Periventricular Hemorrhagic Infarction in Very Preterm Infants: Characteristic Sonographic Findings and Association with Neurodevelopmental Outcome at Age 2 Years (original) (raw)
journal of nature and science of medicine, 2020
Objectives: A proper neurobehavioral development is important for acquiring the skills of a healthy and productive life. Determining intraventricular hemorrhage (IVH) impact on different aspects of development may help in mitigation, and probably, prevention of the developmental delays. Materials and Methods: We evaluated the developmental quotients (DQ) of very low birth weight (VLBW) infants, who experienced IVH during neonatal period, at 24–36 months of their corrected age, using Gesell schedules of child development. Furthermore, we assessed the relationship between the severity, extent and sidedness of IVH, and total DQ, its subdomains, and common neurological and non‑neurological comorbidities. Results: The study included 54 patients (36 males and 18 females). Bilateral IVH was more common in females, who exhibited also a trend toward left‑sided IVH. Patient’s sex, birth‑weight, and gestational age, however, have not shown significant associations with the total DQ, or its subdomains. Severe IVH was significantly associated with both cerebral palsy, and reduction in total DQ, but not in its personal‑social subdomain. Left‑sided IVH was associated with a significant reduction in total DQ, but right‑sidedness showed no such association. Periventricular leukomalacia was significantly associated with reduction in total DQ and in its personal‑social subdomain. No significant associations were detected in patients with the non‑neurological comorbidities. Conclusions: VLBW infants with left‑sided, bilateral or severe IVH are at higher risk of worse neurobehavioral outcomes at 24–36 months of age. Non‑neurological comorbidities seem to have little impact on the DQ and its subdomains assessed at this age.
Grading of Intraventricular Hemorrhage and Neurodevelopment in Preterm <29 Weeks’ GA in Canada
Children
Objective: The aim of this study was to evaluate the neurodevelopmental outcome at 18–24 months in surviving preterm infants with grades I–IV intraventricular hemorrhages (IVHs) compared to those with no IVH. Study Design: We included preterm survivors <29 weeks’ GA admitted to the Canadian Neonatal Network’s NICUs from April 2009 to September 2011 with follow-up data at 18–24 months in a retrospective cohort study. The neonates were grouped based on the severity of the IVH detected on a cranial ultrasound scan and recorded in the database: no IVH; subependymal hemorrhage or IVH without ventricular dilation (grades I–II); IVH with ventricular dilation (grade III); and persistent parenchymal echogenicity/lucency (grade IV). The primary outcomes of neurodevelopmental impairment (NDI), significant neurodevelopmental impairment (sNDI), and the effect modification by other short-term neonatal morbidities were assessed. Using multivariable regression analysis, the adjusted ORs (AOR) an...