Outcome of Premature Infants Born Prior to 32 Weeks' Gestation with Intraventricular Hemorrhage

Abstract

Objective: Intraventricular hemorrhage (IVH) is a frequent neonatal complication in infants born prematurely. This study examined the developmental outcome from 6 months to 2 years of age of very low birth-weight (VLBW) infants born prior to 32 weeks' gestation who had perinatal IVH. Materials and Methods: Fifty-five VLBW infants, 17 with mild IVH, four with severe IVH or periventricular leukomalacia (PVL) and 34 with no IVH, were tested using the Bayley Scales of Infant Development at corrected ages of 6, 12, 18 and 24 months. Motor and mental developmental outcomes in the three groups were compared. Multiple stepwise logistic regression was used to identify associations among medical factors, ultrasound findings and developmental outcome. Results: The mean mental development index (MDI) in the mild IVH and severe IVH and PVL groups was lower than that in the normal group at 12 months (p = 0.026). The mean psychomotor development index (PDI) in the mild IVH and severe IVH or PVL groups was lower than that in the normal group at 12 (p = 0.013), 18 (p = 0.0027) and 24 months (p = 0.004). IVH or PVL was a significant risk factor for impaired 1-year mental outcome (MDI, < 70; odds ratio, 6.0; 95% confidence interval, 1.83 to 19.7) and 1- and 2-year motor outcome (PDI, < 70; odds ratio, 4.22; 95% confidence interval, 1.4 to 12.67 and odds ratio, 4.68; 95% confidence interval, 1.47 to 14.91, respectively). Conclusion: In VLBW infants born prior to 32 weeks' gestation, IVH is a risk factor for impaired development. Its effects on psychomotor development, but not mental development, are still apparent at 2 years of age.

Keywords

• intraventricular hemorrhage
• low birth weight
• risk factors