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Epidemiology of post-hemorrhagic ventricular dilatation in very preterm infants

Journal of Perinatology volume 42, pages 1392–1399 (2022)Cite this article

Subjects

Abstract

Objective

To describe the incidence, trends, management’s variability and short-term outcomes of preterm infants with severe post-hemorrhagic ventricular dilatation (sPHVD).

Methods

We reviewed infants <33 weeks’ gestation who had PHVD and were admitted to the Canadian Neonatal Network between 2010 and 2018. We compared perinatal characteristics and short-term outcomes between those with sPHVD and those with mild/moderate PHVD and those with and without ventriculo-peritoneal (VP) shunt.

Results

Of 29,417 infants, 2439 (8%) had PHVD; rate increased from 7.3% in 2010 to 9.6% in 2018 (P = 0.005). Among infants with PHVD, sPHVD (19%) and VP shunt (29%) rates varied significantly across Canadian centers and between geographic regions (P < 0.01 and P = 0.0002). On multivariable analysis, sPHVD was associated with greater mortality, seizures and meningitis compared to mild/moderate PHVD.

Conclusions

Significant variability in sPHVD and VP shunt rates exists between centers and regions in Canada. sPHVD was associated with increased mortality and morbidities.

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Fig. 1: Study population flow chart.
Fig. 2: Adjusted Standardized Ratios of Severe PHVD Between Canadian Tertiary Neonatal Units Abbreviation: sPHVD, severe post-hemorrhagic ventricular dilatation.

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Acknowledgements

The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada for organizational support. We also thank Heather McDonald Kinkaid, PhD, a scientific writer at MiCare, for editorial support in preparing this manuscript.

Funding

The project described in this manuscript was conducted with no specific financial support. No honorarium, grant, or other form of payment was given to anyone to produce this manuscript. Organizational support for the Canadian Neonatal Network™ was provided by the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CIHR) (CTP 87518) and Mount Sinai Hospital. PS holds a CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research (APR-126340).

Author information

Authors and Affiliations

  1. Department of Pediatrics, IWK Health Centre and Dalhousie University, Halifax, NS, Canada

    Jehier Afifi & Walid El-Naggar

  2. Maternal-infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada

    Prakesh S. Shah & Xiang Y. Ye

  3. Departments of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada

    Prakesh S. Shah, Vibhuti Shah & Edmond Kelly

  4. Department of Pediatrics, CHU de Québec-Université Laval, Québec, QC, Canada

    Bruno Piedboeuf

  5. Department of Pediatrics, CHU Sainte Justine, Québec, QC, Canada

    Keith Barrington

  6. Director, Canadian Neonatal Network and Site Investigator, Mount Sinai Hospital, Toronto, ON, Canada

    Prakesh Shah

  7. Associate Director, Canadian Neonatal Network and Site Investigator, Montreal Children’s Hospital at McGill University Health Centre, Montréal, QC, Canada

    Marc Beltempo

  8. Victoria General Hospital, Victoria, BC, Canada

    Jaideep Kanungo

  9. British Columbia Women’s Hospital, Vancouver, BC, Canada

    Jonathan Wong

  10. Royal Columbian Hospital, New Westminster, BC, Canada

    Zenon Cieslak

  11. Surrey Memorial Hospital, Surrey, BC, Canada

    Rebecca Sherlock

  12. Foothills Medical Centre, Calgary, AB, Canada

    Ayman Abou Mehrem

  13. Royal Alexandra Hospital, Edmonton, AB, Canada

    Jennifer Toye, Khalid Aziz & Joseph Ting

  14. Alberta Children’s Hospital, Calgary, AB, Canada

    Carlos Fajarado

  15. Regina General Hospital, Regina, SK, Canada

    Jaya Bodani

  16. Jim Pattison Children’s Hospital, Saskatoon, SK, Canada

    Lannae Strueby

  17. Winnipeg Health Sciences Centre, Winnipeg, MB, Canada

    Mary Seshia & Deepak Louis

  18. St.Boniface General Hospital, Winnipeg, MB, Canada

    Ruben Alvaro

  19. Hamilton Health Sciences Centre, Hamilton, ON, Canada

    Amit Mukerji

  20. London Health Sciences Centre, London, ON, Canada

    Orlando Da Silva

  21. Windsor Regional Hospital, Windsor, ON, Canada

    Sajit Augustine

  22. Hospital for Sick Children, Toronto, ON, Canada

    Kyong-Soon Lee

  23. Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Eugene Ng

  24. The Ottawa Hospital, Ottawa, ON, Canada

    Brigitte Lemyre

  25. Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Thierry Daboval

  26. Kingston General Hospital, Kingston, ON, Canada

    Faiza Khurshid

  27. Jewish General Hospital, Montréal, QC, Canada

    Victoria Bizgu

  28. Hôpital Sainte-Justine, Montréal, QC, Canada

    Anie Lapointe & Guillaume Ethier

  29. Centre Hospitalier Universitaire de Québec, Sainte Foy, QC, Canada

    Christine Drolet

  30. Montreal Children’s Hospital at McGill University Health Centre, Montréal, QC, Canada

    Martine Claveau

  31. Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada

    Marie St-Hilaire

  32. Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada

    Valerie Bertelle & Edith Masse

  33. Moncton Hospital, Moncton, NB, Canada

    Roderick Canning

  34. Dr. Everett Chalmers Hospital, Fredericton, NB, Canada

    Hala Makary

  35. Saint John Regional Hospital, Saint John, NB, Canada

    Cecil Ojah

  36. Janeway Children’s Health and Rehabilitation Centre, St. John’s, NL, Canada

    Julie Emberley

  37. Cape Breton Regional Hospital, Sydney, NS, Canada

    Andrzej Kajetanowicz

  38. (Chairman, Canadian Neonatal Network), Mount Sinai Hospital, Toronto, ON, Canada

    Shoo K. Lee

Authors
  1. Jehier Afifi
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  2. Prakesh S. Shah
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  3. Xiang Y. Ye
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  4. Vibhuti Shah
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  5. Bruno Piedboeuf
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  6. Keith Barrington
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  7. Edmond Kelly
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  8. Walid El-Naggar
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Consortia

Canadian Neonatal Network Investigators

  • Prakesh Shah
  • , Marc Beltempo
  • , Jaideep Kanungo
  • , Jonathan Wong
  • , Zenon Cieslak
  • , Rebecca Sherlock
  • , Ayman Abou Mehrem
  • , Jennifer Toye
  • , Khalid Aziz
  • , Joseph Ting
  • , Carlos Fajarado
  • , Jaya Bodani
  • , Lannae Strueby
  • , Mary Seshia
  • , Deepak Louis
  • , Ruben Alvaro
  • , Amit Mukerji
  • , Orlando Da Silva
  • , Sajit Augustine
  • , Kyong-Soon Lee
  • , Eugene Ng
  • , Brigitte Lemyre
  • , Thierry Daboval
  • , Faiza Khurshid
  • , Victoria Bizgu
  • , Anie Lapointe
  • , Guillaume Ethier
  • , Christine Drolet
  • , Martine Claveau
  • , Marie St-Hilaire
  • , Valerie Bertelle
  • , Edith Masse
  • , Roderick Canning
  • , Hala Makary
  • , Cecil Ojah
  • , Julie Emberley
  • , Andrzej Kajetanowicz
  •  & Shoo K. Lee

Contributions

JA conceptualized and designed the study, drafted the manuscript, and adjusted the manuscript according to the comments of co-authors. WE and PS overviewed the study design and interpretation of data and provided critical revision of the manuscript for important intellectual content. PS and XY had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the analysis. All authors provided review and critical appraisal of the manuscript and approved the final version to be published.

Corresponding author

Correspondence to Jehier Afifi.

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The authors declare no competing interests.

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Afifi, J., Shah, P.S., Ye, X.Y. et al. Epidemiology of post-hemorrhagic ventricular dilatation in very preterm infants. J Perinatol 42, 1392–1399 (2022). https://doi.org/10.1038/s41372-022-01483-6

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