Long-term neurodevelopmental outcome following low grade intraventricular hemorrhage in premature infants. (February 2018)

• Record Type: Journal Article
• Authors: Pfahl, Sebastian; Hoehn, Thomas; Lohmeier, Klaus; Richter-Werkle, Renate; Babor, Florian; Schramm, Dirk; Sabir, Hemmen
• Is Part Of: Early human development. Volume 117(2018)
• Page Start: 62
• Page End: 67
• Publication Date: 2018-02
• Subjects: BSID II Bayley Scales of Infant Development, Second Edition -- CP cerebral palsy -- IVH Intraventricular hemorrhage -- MDI Mental developmental index -- MRI Magnetic resonance imaging -- PDI Psychomotor developmental index -- PDA Patent ductus arteriosus -- SD Standard deviation; Extremely low birth weight infants -- Intraventricular hemorrhage -- Long term outcome; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2017.12.013
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: Intraventricular hemorrhage (IVH) is one of the most formidable neurological complications in premature infants. Low grade IVH is often regarded as a low risk factor for long-term neurological impairment. Methods: We retrospectively investigated, if there was an association of low IVH grade and adverse neurological outcome in survivors at 20–24 months of corrected age. Results: 89 infants, median gestational age 27 + 4, were included in the study. In total 55 children with IVH grade I ( n = 34) or grade II ( n = 21), plus 34 children with IVH grade III ( n = 13) and IVH grad IV ( n = 21) were included. In infants with grade I and II IVH median mental developmental index (MDI) and psychomotor developmental index (PDI) were 90 and 88, respectively. In total 18 children (33%) had a MDI one standard deviation below the mean (< 85, < 1SD). 9 out of these 18 had an IVH grade I. 17 infants (31%) had a PDI < 1 SD. An MDI/PDI < 2SD was only found in 7 (13%)/6 (11%) children, respectively. Regression analysis showed that IVH grade ( p < 0, 001) and gestational age ( p = 0, 008) were significant independent risk factors for an adverse motoric outcome. Conclusion: Our collective revealed that an IVH grade I was not always associated with a good outcome. Interpretation and prediction of long outcome prognosis after IVH grade I or II requires careful consideration as it might be associated with increased disability. Highlights: Intraventricular hemorrhage (IVH) is one of the most formidable neurological complications in premature infants Low grade IVH is often regarded by neonatologists as a low risk factor for long-term neurological impairment. Here we show, that even low grade IVH can be associated with abnormal neurodevelopmental outcome Prediction of outcome prognosis after low grade IVH requires careful consideration when asked by the patient's parents