Risk factors for the development of intraventricular hemorrhage in preterm infants with respiratory distress syndrome

Intraventricular hemorrhage remains a serious complication in infants and especially in preterm infants with gestational age up to 27 weeks.

Objective. To assess the risk factors for the development of intraventricular hemorrhage in deeply preterm infants with respiratory distress syndrome.

Materials and methods. We carried out a prospective controlled comparative study. The study included 104 newborns with respiratory distress syndrome with a gestational age of less than 32 weeks and a birth weight of less than 1500 g. Depending on the presence of intraventricular hemorrhage the patients were divided into groups: Group I : 56 preterm infants with intraventricular hemorrhage verified during the observation; Group II: 48 preterm infants without intraventricular hemorrhage

Results. The groups at birth were comparable in terms of weight and height. We identified the risk factors contributing to the development of intraventricular hemorrhage: the absence of antenatal prophylaxis of fetal respiratory distress syndrome (odds ratio (OR) 2.728; 95% CI 1.218–6.109), tracheal intubation in the delivery room (OR 5.714; 95% CI 1.610–20.28), the need for mechanical ventilation on the first day life (OR 2.713; 95% CI 1.154–6.377), forced mechanical ventilation (OR 9.818; 95% CI 1.039–92.86), > 20 manipulations in the first day of life (OR 2.747; 95% CI 1.240–6.089). Also, the authors determined the factors contributing to a decrease in the development of intraventricular hemorrhage: complete antenatal prevention of fetal respiratory distress syndrome (OR 0.35; 95% CI 0.149–0.825), less invasive administration of poractant-alpha at a dosage of 200 mg/kg (OR 0.161; 95% CI 0.033–0.787), ventilation with double control during inspiration (OR 0.159; 95% CI 0.032–0.784), chronic arterial hypertension in the mother during the present pregnancy (OR 0.185; 95% CI 0.037–0.919).

Conclusion. According to the results of the study the authors identified significant risk factors for the development of intraventricular hemorrhage in deeply preterm infants with respiratory distress syndrome.

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