Abstract
Perinatal factors were recorded from one hundred inborn VLBW neonates, studied consecutively. Their mean (± SE) gestational age (GA) was 29 ± 0.4 weeks and their mean birthweight (BWt) was 1094 ± 45 g. Cranial ultrasound was used to diagnose the presence and severity of ICH. The incidence of ICH was 32%, 18% being major and 14% minor. The mortality from ICH was 34%, representing 56% of those with major and 7% of those with minor ICH. Univariate analysis showed that only premature labor (prem lab) and vaginal delivery (vag del) were significantly associated with the diagnosis of ICH. The reduced incidence of ICH associated with cesarean section was noted only if the presentation was vertex. Using stepwise logistic regression to build a model from potential risk factors, prem lab, admission PaCO2 (AdPaCO2), Apgar at 1 min and vag del were identified as the most predictive factors for ICH. The most predictive factors in those <30 wks GA were prem lab and artificial ventilation for greater than 24 hours (IMV>24 hrs), and in those ⩾30 wks were vag del, Apgar at 5 min and AdPaCO2. The occurrence of major ICH was predicted best by GA, IMV>24 hrs. and prem lab. ICH in the VLBW neonate relates to the presence of prem lab and respiratory distress in the very immature neonate, while mode of delivery and early respiratory care are important in the more mature high risk preterm neonate.
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Hutchison, A., Barrett, J., Fleischer, A. et al. ASSOCIATION OF PERINATAL FACTORS WITH INTRACRANIAL HEMORRHAGE (ICH) IN THE VERY LOW BIRTHWEIGHT (VLBW) PRETERM NEONATE. Pediatr Res 18 (Suppl 4), 328 (1984). https://doi.org/10.1203/00006450-198404001-01412
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DOI: https://doi.org/10.1203/00006450-198404001-01412