Intraventricular hemorrhage risk factors in very low birth weight newborns: a case-control study

被引:0
作者
Martins, Laura [1 ]
Borges, Maria Joao [2 ]
Gomes, Sonia Melo [3 ]
Macedo, Israel [4 ]
Nona, Jose [4 ]
Pinto, Filomena [4 ]
Faria, Conceicao [4 ]
Nascimento, Odilia [5 ]
Valido, Antonio Marques [5 ]
机构
[1] EPE, Hosp Espirito Santo Evora, Complementary Internship Pediat, Evora, Portugal
[2] Hosp Cent Funchal, Funchal, Portugal
[3] Ctr Hosp Caldas Rainha, Complementary Internship Pediat, Rainha, Portugal
[4] Maternidade Dr Alfredo Costa, Lisbon, Portugal
[5] Maternidade Dr Alfredo Costa, Pediat Dept, Lisbon, Portugal
来源
EINSTEIN-SAO PAULO | 2009年 / 7卷 / 03期
关键词
Intracranial hemorrhages; Risk factors; Infant; very low birth weight; newborn; premature;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Identification of variables that affect the risk of severe intraventricular hemorrhage (IVH) in very low birth weight (VLBW) newborns. Methods: Analytic case-control study, in a population consisting of all VLBW newborns admitted to the Neonatal Intensive Care Unit of a maternity hospital, between January 2002 and December 2007. The authors considered as cases all VLBW newborns with severe IVH (grade >= 3), and control all VLBW newborns without IVH. Independent variables included obstetric, perinatal and neonatal diagnosis and therapy. Bivariate analysis and multivariate logistic regression analysis were performed. Results: During this period, of the 864 VLBW newborns admitted to the Neonatal Intensive Care Unit, 9.7% had severe IVH. With bivariate analysis an association between severe IVH, gestational age and birth weight was found. Prenatal care and pre-eclampsia were associated with a decrease in the incidence of severe IVH. Amnionitis, being outborn, vaginal delivery, male gender, intubation in the delivery room, surfactant, hyaline membrane disease, pneumothorax, necrotizing enterocolitis (NEC) perforation and oscillatory high frequency ventilation were associated with an increased incidence of severe IVH. By multivariate logistic regression, the variables associated with increased risk of severe IVH were: pneumothorax (OR = 3.8; 95% CI = 1.7-8.3), NEC with perforation (OR = 8.8; 95% CI = 1.7-45.0), vaginal delivery (OR = 2.0; 95% CI = 1.0-4.1) and high frequency ventilation (OR = 4.8; 95% CI = 1.3-17.3). The following were protective of severe IVH: gestational age (OR = 0.61; 95% CI = 0.52-0.72), patent ductus arteriosus treatment with indomethacin (OR = 0.26; 95% CI = 0.11-0.6) and fertility treatment (OR = 0.24; 95% CI = 0.06-0.94). Conclusion: These data outline the importance of improvement of pre and neonatal care to reduce severe IVH.
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页码:279 / 283
页数:5
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