Delayed Intraventricular Hemorrhage in Premature Infants.

Min,  Uoo Gyung; Kim,  Hyo Bin; Jun,  Nu Lee; Goo,  Hyun Woo; Yoon,  Jong Hyun; Kim,  Ellen Ai Rhan; Kim,  Ki Soo; Pi,  Soo Young

Original Article

Journal of the Korean Society of Neonatology 2002;9(2):176-185.
Published online November 1, 2002.

Delayed Intraventricular Hemorrhage in Premature Infants.

Uoo Gyung Min, Hyo Bin Kim, Nu Lee Jun, Hyun Woo Goo, Jong Hyun Yoon, Ellen Ai Rhan Kim, Ki Soo Kim, Soo Young Pi

¹Division of Neonatology, Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. arkim@amc.seoul.kr
²Department of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

미숙아의 지연성 뇌실 내 출혈에 대한 연구

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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.

Key Words: Delayed intraventricular hemorrhage; Early intraventricular hemorrhage; Risk factors; Neurologic prognosis; Prematurity