Reduction of severe intraventricular hemorrhage, a tertiary single-center experience: incidence trends, associated risk factors, and hospital policy
Open Access
- 1 December 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Childs Nervous System
- Vol. 36 (12), 2971-2979
- https://doi.org/10.1007/s00381-020-04621-7
Abstract
Objectives To determine the incidence, trends, maternal and neonatal risk factors of severe intraventricular hemorrhage (IVH) among infants born 24-32 weeks and/or < 1500 g, and to evaluate the impact of changing of hospital policies and unit clinical practice on the IVH incidence. Study design Retrospective chart review of preterm infants with a gestational age (GA) of 24-32(6) weeks and/or weight of < 1500 g born at King Abdulaziz Medical City-Riyadh (KAMC-R), Saudi Arabia, from 2016 to 2018. Multivariate logistic regression model was constructed to determine the probability of developing severe IVH and identify associations with maternal and neonatal risk factors. Results Among 640 infants, the overall incidence of severe IVH was 6.4% (41 infants), and its rate decreased significantly, from 9.4% in 2016 to 4.5% and 5% in 2017 and 2018 (p = 0.044). Multivariate analysis revealed that caesarian section delivery decreased the risk of severe IVH in GA group 24-27 weeks (p = 0.045). Furthermore use of inotropes (p = 0.0004) and surfactant (p = 0.0003) increased the risk of severe IVH. Despite increasing use of inotropes (p = 0.024), surfactant therapy (p = 0.034), and need for delivery room intubation (p = 0.015), there was a significant reduction in the incidence of severe IVH following the change in unit clinical practice and hospital policy (p = 0.007). Conclusion Cesarean section was associated with decreased all grades of IVH and severe IVH, while use of inotropes was associated with increased severe IVH. The changes in hospital and unit policy were correlated with decreased IVH during the study period.Keywords
This publication has 37 references indexed in Scilit:
- A Predictive Model for SIVH risk in Preterm Infants and Targeted Indomethacin Therapy for PreventionScientific Reports, 2013
- Cerebral Effects of Commonly Used Vasopressor-Inotropes: A Study in Newborn PigletsPLOS ONE, 2013
- Short-term outcome of very low-birth-weight infants in a tertiary care hospital in Saudi ArabiaAnnals of Saudi Medicine, 2011
- Method of delivery and intraventricular haemorrhage in extremely preterm infantsThe Journal of Maternal-Fetal & Neonatal Medicine, 2010
- Male Gender Is Associated With Intraventricular HemorrhagePediatrics, 2010
- The Diagnosis, Management, and Postnatal Prevention of Intraventricular Hemorrhage in the Preterm NeonateClinics in Perinatology, 2008
- Neonatal Intensive Care Unit Characteristics Affect the Incidence of Severe Intraventricular HemorrhageMedical Care, 2006
- Higher mortality rates among inborn infants admitted to neonatal intensive care units at nightThe Journal of Pediatrics, 2003
- Antenatal corticosteroid therapy: A meta-analysis of the randomized trials, 1972 to 1994American Journal of Obstetrics and Gynecology, 1995
- Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1,500 gmThe Journal of Pediatrics, 1978