Prenatal and perinatal risk and protective factors for neonatal intracranial hemorrhage. National Institute of Child Health and Human Development Neonatal Research Network
S. Shankaran, C. R. Bauer, R. Bain, L. L. Wright and J. Zachary
Wayne State University, Detroit, Mich, USA.
OBJECTIVE: To identify prenatal and perinatal risk and protective factors
for grade III and IV intracranial hemorrhage (ICH) in 4795 singleton
infants (weight, < or = 1500 g). METHOD: Prenatal and perinatal risk and
protective factors for ICH were examined initially by univariate analysis
and adjusted for year of birth, followed by multivariate logistic
regression analysis that adjusted simultaneously for the effects of year of
birth and prenatal and perinatal characteristics. SETTING: Seven tertiary
care neonatal-perinatal centers. RESULTS: By univariate analysis,
African-American race, prenatal care, older maternal age, hypertension or
preeclampsia, antenatal steroid administration, cesarean section delivery,
increasing birth weight, increasing gestational age, and female gender of
the infant were protective prenatal or perinatal factors. Antepartum
hemorrhage, the presence of labor, and breech presentation were perinatal
factors that were associated with an increased risk of ICH. By using staged
logistic regression, a model of combined prenatal and perinatal
characteristics that influenced grade III and IV ICH was developed.
Significant protective factors against ICH included a complete course of
antenatal steroid therapy, African-American maternal race, female gender of
the infant, hypertension or preeclampsia with no antepartum hemorrhage,
increasing gestational age, and increasing birth weight. CONCLUSION:
Antenatal steroid administration is a therapeutic intervention that is
associated with a decreased risk for neonatal grade III and IV ICH.
Delivery Mode and Severe Intraventricular Hemorrhage in Single, Very Low Birth Weight, Vertex Infants
Riskin et al.
Obstet Gynecol 2008;112:21-28.
ABSTRACT
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Effects of gestational age and prenatal and perinatal events on the coagulation status in premature infants
Salonvaara et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2003;88:F319-F323.
ABSTRACT
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Risk Factors for Intraventricular Hemorrhage in Very Low Birth Weight Premature Infants: A Retrospective Case-Control Study
Linder et al.
Pediatrics 2003;111:e590-595.
ABSTRACT
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Perinatal risk factors for major intraventricular haemorrhage in the Australian and New Zealand Neonatal Network, 1995-97
Heuchan et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2002;86:F86-F90.
ABSTRACT
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Outcome of Children in the Indomethacin Intraventricular Hemorrhage Prevention Trial
Ment et al.
Pediatrics 2000;105:485-491.
ABSTRACT
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Cranial Sonography in Very-Low-Birth-Weight Infants: Do All Infants Need to Be Screened?
Paul et al.
CLIN PEDIATR 1999;38:503-509.
ABSTRACT
Maternal hypertension and neurodevelopmental outcome in very preterm infants
Gray et al.
Arch. Dis. Child. Fetal Neonatal Ed. 1998;79:88F-93.
ABSTRACT
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Antenatal Phenobarbital Therapy and Neonatal Income
Thorp et al.
Pediatrics 1997;99:751-751.
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INTRACRANIAL HEMORRHAGE IN PREMATURE BABIES
JWatch General 1996;1996:6-6.
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