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Outcomes of extremely preterm infants following severe intracranial hemorrhage

Journal of Perinatology volume 34, pages 203–208 (2014)Cite this article

Subjects

Abstract

Objective:

Severe intracranial hemorrhage (ICH) is an important prognostic variable in extremely preterm (EPT) infants. We examined imaging and clinical variables that predict outcomes in EPT infants with severe ICH.

Study design:

Retrospective analysis of 353 EPT infants with severe ICH. Outcomes were compared by examining: (i) unilateral vs bilateral ICH; and (ii) presence vs absence of hemorrhagic parenchymal infarction (HPI). Regression analyses identified variables associated with death or neurodevelopmental impairment (NDI).

Result:

Bilateral ICH and HPI had higher rates of adverse outcomes and were independently associated with death/NDI. HPI was the most important variable for infants of lower birth weight, and bilateral ICH for larger infants. For infants surviving to 36 weeks, shunt placement was most associated with death/NDI.

Conclusion:

Bilateral ICH and the presence of HPI in EPT infants with severe ICH are associated with death/NDI, though the importance depends on birth weight and survival to 36 weeks.

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Acknowledgements

We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. Investigators, in addition to those listed as authors, who participated in this study are listed in the Appendix. The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development provided grant support for the Neonatal Research Network’s Generic Database Study and Follow-up Study.

Author information

Authors and Affiliations

  1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA

    A S Davis & S R Hintz

  2. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA

    R F Goldstein

  3. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA

    N Ambalavanan

  4. Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, USA

    C M Bann

  5. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    B J Stoll & E C Hale

  6. Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA

    E F Bell

  7. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    S Shankaran

  8. Department of Pediatrics, Brown University, Providence, RI, USA

    A R Laptook

  9. Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA

    M C Walsh & N S Newman

  10. Statistics and Epidemiology Unit, RTI International, Rockville, MD, USA

    A Das

  11. Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    R D Higgins

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  1. A S Davis
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  6. B J Stoll
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  7. E F Bell
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  10. M C Walsh
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  11. E C Hale
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  13. A Das
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for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

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Correspondence to A S Davis.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Davis, A., Hintz, S., Goldstein, R. et al. Outcomes of extremely preterm infants following severe intracranial hemorrhage. J Perinatol 34, 203–208 (2014). https://doi.org/10.1038/jp.2013.162

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  • DOI: https://doi.org/10.1038/jp.2013.162

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