Affiliations: Department of Pediatrics and Communicable Diseases, Division of Neonatal-Perinatal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
Note:  Corresponding author: Dr. Rebecca J. Vartanian, 18-621 Mott Hospital, 40 E. Medical Center Drive, Ann Arbor, MI 48109, USA. Tel.: +1 734 763 4109; Fax: +1 734 763 2278; E-mail: [email protected]
Abstract: Objective: To determine the likelihood of intraventricular hemorrhage (IVH) occurring after the first three days of life and to develop a predictive model for late IVH in preterm infants. Methods: A retrospective study was conducted on very low birth weight infants with grades IVH II-IV. IVH was considered early if detected by ultrasound within the first three days of life and it was considered late if detected beyond this time. Infants with late IVH had at least one documented negative ultrasound scan on or after day of life three. Data were evaluated for associated risk factors using univariate and logistic regression analyses. Results: One-hundred thirty infants with IVH grades II-IV met the inclusion criteria. Early IVH occurred in 82 (63%) and late IVH occurred in 48 (37%). Infants with late IVH were more commonly exposed to prenatal steroids (OR 4.2, 95% CI 1.5–12.0), cesarean delivery (OR 2.8, 95% CI 1.1–7.0), or had symptomatic PDA requiring medical or surgical therapy prior to IVH detection (OR 12.0, 95% CI 3.8–37.7) compared to infants with early IVH. Conclusions: IVH after day of life three is not rare in VLBW infants. Further exploration of risk factors associated with late IVH compared to infants without IVH through interventional trials is warranted.
Keywords: Very low birth weight, intraventricular hemorrhage, ultrasonography, premature