FREQUENCY AND GRADING OF INTRAVENTRICULAR HEMORRHAGE IN PRETERM BABIES ADMITTED IN NATIONAL INSTITUTE OF CHILD HEALTH, KARACHI, PAKISTAN
Article Sidebar
Main Article Content
Abstract
Objective: To report the frequency of IVH in preterm neonates and IVH grading on cranial ultrasound.
Methodology: This prospective cross-sectional study was carried out at NICH. All preterm infants of either gender were consecutively enrolled. Detailed history of the infant regarding the clinical examination and socio-demographic characteristics of the infants were noted. IVH was observed in all preterm neonates, and all infants were categorized according to the Papile grading.
Results: Of 144 neonates, the mean age was 2.34 ±0.97 days. There were 93 (64.6%) males and 51 (35.4%) females. IVH was observed in 144 (37.6%) neonates. A significant mean difference of age (p: <0.001), gestational age (p: <0.001), birth weight (p: <0.001), APGAR score at 1 min (p; <0.001), APGAR score at 5 min (p: <0.001) was observed in between IVH and non IVH neonates. Furthermore, a significant association of place of admission (p: <0.001), mode of delivery (p: 0.038), need of invasive/non-invasive ventilator (p: 0.002), and preterm status (p: <0.001) was observed with IVH. IVH grade I was observed in 75 (52.1%), grade II in 45 (31.3%), grade III in 18 (12.5%), and grade IV in 6 (4.2%) neonates.
Conclusion: A notably higher number of preterm neonates had IVH. While grade I was most common, a majority exhibited severe grades (III and IV). Extremely early preterm births carried increased risk of spontaneous delivery and greater reliance on invasive/non-invasive ventilator support.
Article Details
Work published in JPMI is licensed under a
Creative Commons Attribution-NonCommercial 2.0 Generic License.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Suff N, Story L, Shennan A. The prediction of preterm delivery: What is new? Semin Fetal Neonatal Med. 2019;24(1):27-32. doi: 10.1016/j.siny.2018.09.006.
Walani SR. Global burden of preterm birth. Int J Gynaecol Obstet. 2020;150(1):31-33. doi: 10.1002/ijgo.13195.
Cao G, Liu J, Liu M. Global, Regional, and National Incidence and Mortality of Neonatal Preterm Birth, 1990-2019. JAMA Pediatr. 2022;176(8):787-796. doi: 10.1001/jamapediatrics.2022.1622.
Lincetto O, Banerjee A. World Prematurity Day: improving survival and quality of life for millions of babies born preterm around the world. Am J Physiol Lung Cell Mol Physiol. 2020;319(5):L871-L874. doi: 10.1152/ajplung.00479.2020.
Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019;7:e37–e46. doi:10.1016/S2214-109X(18)30451-0.
Skiöld B, Hallberg B, Vollmer B, Ådén U, Blennow M, Horsch S. A Novel Scoring System for Term-Equivalent-Age Cranial Ultrasound in Extremely Preterm Infants. Ultrasound Med Biol. 2019;45(3):786-794. doi: 10.1016/j.ultrasmedbio.2018.11.005.
Parodi A, Govaert P, Horsch S, Bravo MC, Ramenghi LA; eurUS.brain group. Cranial ultrasound findings in preterm germinal matrix haemorrhage, sequelae and outcome. Pediatr Res. 2020;87(Suppl 1):13-24. doi: 10.1038/s41390-020-0780-2.
Mohammad K, Scott JN, Leijser LM, Zein H, Afifi J, Piedboeuf B, et al. Consensus Approach for Standardizing the Screening and Classification of Preterm Brain Injury Diagnosed With Cranial Ultrasound: A Canadian Perspective. Front Pediatr. 2021;9:618236. doi: 10.3389/fped.2021.618236.
Gilard V, Tebani A, Bekri S, Marret S. Intraventricular Hemorrhage in Very Preterm Infants: A Comprehensive Review. J Clin Med. 2020;9(8):2447. doi: 10.3390/jcm9082447.
Özek E, Kersin SG. Intraventricular hemorrhage in preterm babies. Turk Pediatri Ars. 2020;55(3):215-221. doi: 10.14744/TurkPediatriArs.2020.66742.
Siffel C, Kistler KD, Sarda SP. Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review. J Perinat Med. 2021;49(9):1017-1026. doi: 10.1515/jpm-2020-0331.
Lien R. Neurocritical care of premature infants. Biomed J. 2020;43(3):259-267. doi: 10.1016/j.bj.2020.03.007.
Rehan N, Farooqui R, Niazi A, Khan MAR. Significance of cranial ultrasound in detection of intraventricular haemorrhage in prematures. Ann Pak Inst Med Sci. 2009; 5(4): 255-258.
Gaberel T, Magheru C, Emery E. Management of non-traumatic intraventricular hemorrhage. Neurosurg Rev. 2012;35(4):485-95.
Al-Abdi SY, Al-Aamri MA. A systematic review and meta-analysis of the timing of early intraventricular hemorrhage in preterm neonates: clinical and research implications. J Clin Neonatol. 2014;3(2):76.
Salih BK, Rabaty AA. Role of intracranial ultrasonography in the evaluation of premature babies. Med J Babylon. 2019;16(3):215-9.
Al-Mouqdad M, Al-Abdi S, Scott JN, Hurley A, Tang S, Creighton D, et al. A new IVH scoring system based on laterality enhances prediction of neurodevelopmental outcomes at 3 years age in premature infants. Am J Perinatol. 2017;34(01):44-50.
Egwu CC, Ogala WN, Farouk ZL, Tabari AM, Dambatta AH. Factors associated with intraventricular hemorrhage among preterm neonates in Aminu Kano teaching hospital. Niger J Clin Pract. 2019;22(3):298-304. doi: 10.4103/njcp.njcp_154_18.
Linder N, Haskin O, Levit O, Klinger G, Prince T, Naor N. Risk factors for IVH in VLBW premature infants: a retrospective case – control study. Pediatr. 2003;111: 590-95.