J Korean Med Sci.  2015 Oct;30(Suppl 1):S52-S58. 10.3346/jkms.2015.30.S1.S52.

Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus among Very-Low-Birth-Weight Infants in Korea

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Departmemt of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
  • 3Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. sinky@catholic.ac.kr

Abstract

Here, we aimed to evaluate the incidence and mortality of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHH) among very-low-birth-weight (VLBW) infants in Korea and assess the associated factors of PHH. This cohort study used prospectively collected data from the Korean Neonatal Network (KNN). Among 2,386 VLBW infants in the KNN database born between January 2013 and June 2014, 63 infants who died without brain ultrasonography results were excluded. Maternal demographics and neonatal clinical characteristics were assessed. The overall incidence of IVH in all the VLBW infants was 42.2% (987 of 2,323), while those of IVH grade 1, 2, 3, and 4 were 25.1%, 7.0%, 4.8%, and 5.5%, respectively. The incidence and severity of IVH showed a negatively correlating trend with gestational age and birth weight. PHH developed in 0%, 3.5%, 36.1%, and 63.8% of the surviving infants with IVH grades 1, 2, 3, and 4, respectively. Overall, in the VLBW infants, the IVH-associated mortality rate was 1.0% (24/2,323). Only IVH grade severity was proven to be an associated with PHH development in infants with IVH grades 3-4. This is the first Korean national report of IVH and PHH incidences in VLBW infants. Further risk factor analyses or quality improvement studies to reduce IVH are warranted.

Keyword

Infant, Newborn; Infant, Premature; Infant, Very-Low-Birth-Weight; Intracranial Hemorrhage; Hydrocephalus; Registries; Incidence; Epidemiology

MeSH Terms

Birth Weight
Cerebral Hemorrhage/*epidemiology/mortality/pathology
Cohort Studies
Databases, Factual
Echoencephalography
Female
Gestational Age
Humans
Hydrocephalus/*epidemiology/mortality/pathology
Incidence
Infant
Infant Mortality
Infant, Newborn
*Infant, Very Low Birth Weight
Male
Odds Ratio
Republic of Korea/epidemiology
Retrospective Studies
Severity of Illness Index

Figure

  • Fig. 1 Incidence of intraventricular hemorrhage (IVH) according to gestational age (GA) (A) and birth weight (BW) (B). The proportions of infants with grades 1, 2, 3, and 4 IVH and without IVH are presented according to GA and BW.

  • Fig. 2 Survival period of infants who expired primarily of intraventricular hemorrhage (IVH). The time of death is shown in terms of postnatal age (day). The median and interquartile range (25%-75%) are indicated.

  • Fig. 3 Cross-national comparisons of intraventricular hemorrhage incidences. Incidences of grade 2-4 (A) or grade 3-4 IVH (B) in the KNN were compared with those of the ANZNN, CNN, NICHD, and EuroNeoNet registries. IVH, intraventricular hemorrhage; KNN, Korean Neonatal Network; ANZNN, Australian and New Zealand Neonatal Network; CNN, Canadian Neonatal Network; NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Development; EuroNeoNet, European Neonatal Network; GW, gestational weeks.


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The Long-Term Outcome and Rehabilitative Approach of Intraventricular Hemorrhage at Preterm Birth
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