Incidence and Risk Factors of Intraventricular Hemorrhage in Early Preterm Infants: A Cross-Sectional Study

Background: Early preterm infants are susceptible to a serious disorder called intraventricular hemorrhage (IVH), which may cause severe neurological damage. Objective: To determine the incidence of IVH in preterm infants at Lady Reading Hospital, Peshawar, Pakistan, and to identify associated risk factors and potential preventive measures. Methodology: This cross-sectional research examined the prevalence of IVH among early preterm infants and was carried out at Lady Reading Hospital in Peshawar from 1 January 2021 to 31 December 2023. After excluding individuals with congenital defects, insufficient medical records, or non-consent, the research comprised 210 newborns born before 28 weeks of gestation and diagnosed with IVH during the first 72 hours of life. Medical record reviews and in-person observations were used to gather data, with an emphasis on clinical, risk, and demographic characteristics. Using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY) with a significance threshold of p < 0.05, descriptive techniques were used in the statistical studies to summarize the features and inferential approaches, such as univariate and multivariate logistic regression, to identify IVH risk variables. Results: Among the 210 early preterm newborns studied, the frequency of IVH according to severity was as follows: 79 infants (37.62%) had Grade I, 65 infants (30.95%) had Grade II, 39 infants (18.57%) had Grade III, and 27 infants (12.86%) had Grade IV. Three key demographic findings were that 63 births (30.00%) occurred before 26 weeks of gestation, 87 infants (41.43%) had birth weights of less than 1000 grams, and 111 infants (52.86%) were male. Significant predictors of IVH identified through multivariate logistic regression included birth weight less than 1000 grams (odds ratio (OR) = 3.10, 95% confidence interval (CI): 1.78-5.42, p < 0.01), gestational age less than 26 weeks (OR = 2.68, 95% CI: 1.50-4.76, p < 0.01), Apgar score <= 5 (OR = 4.01, 95% CI: 2.23-7.21, p < 0.01), resuscitation at birth (OR = 2.23, 95% CI: 1.12-4.45, p = 0.02), mechanical ventilation (OR = 3.55, 95% CI: 1.85-6.82, p < 0.01), and sepsis (OR = 2.98, 95% CI: 1.50-5.92, p = 0.02). Conclusion: The high incidence of IVH and its association with critical risk factors underscore the need for improved neonatal care practices and targeted interventions in early preterm infants.