J Korean Soc Neonatol.  2002 Nov;9(2):176-185.

Delayed Intraventricular Hemorrhage in Premature Infants

• Min UG
• Kim HB
• Jun NL
• Goo HW
• Yoon JH
• Kim EA
• Kim KS
• Pi SY

Abstract

PURPOSE: To determine incidence, characteristics and risk factors associated with delayed intraventricular hemorrage (IVH) in infants under 34 weeks old.
METHODS
The medical records of infants with IVH admitted to neonatal intensive care unit of Asan Medical Center from January 1999 to December 2001 were reviewed retrospectively. Infants whose IVH was detected within 7 days of life and after 21 days of life were defined as "early hemorrahge group" and "delayed hemorrhage group", respectively. Various antenatal and neonatal factors were compared between these groups and risk factors leading to delayed IVH were identified.
RESULTS
The incidence of delayed IVH was 28/103 (27.2%). The mean gestational age in delayed hemorrhage was 29.2+/-2.8 weeks. Lower birth weight, higher use of postnatal dexamethasone, antenatal dexamethasone and umbilical venous lines were noted in delayed hemorrhage group. Laboratory values associated with delayed IVH included lower platelet counts and hematocrit. Risk factors associated with delayed IVH included low hematocrit and elevated uric acid. Severe IVH (grade III, IV) occurred more in early hemorrhage group and subsequent 12 months follow-up showed developmental delay in 3 (4.0%) and 1 (3.6%) in early and delayed hemorrhage group, respectively.
CONCLUSION
Frequent delayed hemorrhage may occur in infants under 34 weeks old. Although degree of delayed IVH is relatively milder than early hemorrhage group, its association with developmental delay merits follow-up head ultrasonogram up to at least 1 month of age or even longer.

Keyword

Delayed intraventricular hemorrhage; Early intraventricular hemorrhage; Risk factors; Neurologic prognosis; Prematurity

MeSH Terms

Birth Weight
Chungcheongnam-do
Dexamethasone
Follow-Up Studies
Gestational Age
Head
Hematocrit
Hemorrhage*
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature*
Intensive Care, Neonatal
Medical Records
Platelet Count
Retrospective Studies
Risk Factors
Ultrasonography
Uric Acid
Dexamethasone
Uric Acid