In search of general theories

Outcomes of Extremely Preterm Infants Following Severe Intracranial Hemorrhage

03.04.2014 14:47
Journal of Perinatology : Official Journal of the California Perinatal Association
Outcomes of Extremely Preterm Infants Following Severe Intracranial Hemorrhage
AS Davis, SR Hintz, RF Goldstein, N Ambalavanan, CM Bann, BJ Stoll, EF Bell, S Shankaran, AR Laptook, MC Walsh, EC Hale, NS Newman, A Das, RD HigginsDisclosures
J Perinatol. 2014;34(3):203-208. 
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Abstract and Introduction
Methods
Results
Discussion
References
Abstract and Introduction
 
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.