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ISSN: 0031-3939
Pediatria Polska - Polish Journal of Paediatrics
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3/2023
vol. 98
 
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abstract:
Original paper

Intraventricular hemorrhage: morbidity and risk factors in 3rd level centers in South-East Poland

Aleksandra Skubisz
1
,
Witold Błaż
2, 3
,
Krzysztof Gargasz
4
,
Magdalena Pyka
5
,
Małgorzata Stefańska
3, 6
,
Beata Borowiec-Szredzka
7
,
Andrzej Zawora
8
,
Artur Mazur
3

  1. Student Scientific Association of Neonatology, Institute of Medical Sciences, Medical College of Rzeszów University, University of Rzeszów, Rzeszów, Poland
  2. Clinical Department of Neonatology and Neonatal Intensive Care Units, Saint Jadwiga the Queen Clinical Provincial Hospital No. 2, University of Rzeszów, Rzeszów, Poland
  3. Departament of Pediatrics, College of Medical Sciences, Institute of Medical Sciences, University of Rzeszów, Rzeszów, Poland
  4. College of Medical Sciences, Institute of Medical Sciences, University of Rzeszow, Rzeszów, Poland
  5. Research and Development Center, Pro-Familia Hospital, Rzeszów, Poland
  6. Neonatal Clinic with Intensive Care, University Clinical Hospital them. Fryderyk Chopin, University of Rzeszów, Rzeszów, Poland
  7. Neonatology Department with Neonatal Intensive Care, Independent Public Health Care Complex No. 1, Rzeszów, Poland
  8. Neonatology Department, Pro-Familia Hospital, Rzeszów, Poland
Pediatr Pol 2023; 98 (3): 197-202
DOI: https://doi.org/10.5114/polp.2023.131465
Online publish date: 2023/09/21
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Introduction
We describe the incidence of intraventricular hemorrhage (IVH) in preterm infants in all 3rd level centers in Podkarpackie province, Poland. We identify the frequency of risk factors present in this population known to increase the occurrence of IVH, which if changed could result in better treatment outcomes.

Material and methods
The retrospective, observational, multicenter study included 340 preterm infants who were born at ≤ 28 weeks of gestation. Patients hospitalized at 3rd level centers between 2016 and 2020 were enrolled in the analysis.

Results
The incidence of IVH in the study population was 51%, and severe grades of IVH (sIVH) occurred in 24% of all infants. Patients diagnosed with sIVH had significantly more often lower gestational age (p = 0.0005), lower birth weight (p = 0.01), lack of antenatal steroid therapy (p = 0.0004), a partial course of antenatal steroid therapy (p = 0.0009), a lower Apgar score at 1 minute (p < 0.0001), invasive mechanical ventilation use (p < 0.0001) and a lower hematocrit (Hct) level at the first measurement after birth (p = 0.002). After multivariate analysis, the significant risk factors that increased risk of sIVH were: lack of or only a partial course of antenatal steroid therapy (OR: 2.85; 95% CI: 1.18–6.83, p = 0.02, OR: 3.16; 95% CI: 1.49–6.67, p = 0.003 respectively), invasive mechanical ventilation use (OR: 4.75; 95% CI: 2.18–10.34, p < 0.001) and the Hct level < 45% at first measurement (OR: 2.62; 95% CI: 1.28–5.37, p = 0.008).

Conclusions
The occurrence of any grade, but especially a severe grade of IVH is still a very common problem in premature infants. Administering a full course of antenatal steroid therapy, applying interventions to prevent anemia in preterm infants and optimizing ventilation methods may help reduce the incidence of IVH, which will improve patient outcomes.

keywords:

prematurity, brain injury, epidemiology, intraventricular hemorrhage