Abstract 143

Knowledge of the etiology of ICH in contemporary term infants is based on limited numbers of patients. Aim: To identify peripartum factors associated with ICH in neonates >36 weeks gestation with birth weights>2500 grams referred to our hospital. Method: Case records of infants diagnosed with ICH by CT scan or autopsy between 1986-1996 were reviewed. Cases were classified by primary type of ICH: epidural, subdural(SDH), primary subarachnoid (SAH), intraventricular (IVH) and intracerebral(ICbH); mode of delivery; evidence of physical trauma (defined as association with instrumental birth and extracranial injury); presence of asphyxia; and other perinatal factors. Results: Of 161 cases, 65% were in the SDH and IVH groups. 42% had instrumental deliveries, 49% had other evidence of physical trauma and 14% present had birth asphyxia. The incidence rates of physical trauma and of severe asphyxia in IVH and ICbH were higher than in a reference population. Other factors, included cardiac surgery, gastrointestinal anomalies and infections. In 28% no peripartum risk factors were present. Table

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Conclusions: Epidural, SDH and SAH were strongly associated with instrumental delivery and evidence of physical birth trauma. Severe asphyxia was a relatively unimportant etiologic factor.