RISK FACTORS AFFECTING SEVERITY OF INTRAVENTRICULAR HEMORRHAGE IN PRETERM INFANTS OF AN NICU OF A TERTIARY CARE CENTRE

Background: As severe germinal matrix intraventricular haemorrhage (GM-IVH) causes neurological sequelae in 50–75% of preterm survivors, it is still a major global public health problem. [1].By studying the association and severity with risk factors for IVH in preterms we can make preventive measures for the same.

Objective: The purpose of this study is to identify the risk factors associated with the development IVH in the preterm infants of an NICU of a tertiary care centre and the relationship of the severity of disease and these risk factors.

Methods: It is a retrospective study. A total of 160 premature neonates of gestational age ≤34 weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted in neonatal intensive care unit of a tertiary teaching hospital at Pune, Maharashtra. The babies were divided into two groups: GM-IVH and non-IVH. The association and severity of neonatal and maternal risk factors were analysed.

Results: In our study, out of 160 neonates, 75 neonates (46.8%) developed intraventricular haemorrhage, of which 8% developed severe IVH (grade 3 and 4). Use of inotropes (p = 0.008), surfactant (p < 0.0001), blood transfusions(p=0.005),HsPDA(p=0.006) were highly significant for developing intraventricular haemorrhage.

Conclusions: Clinicians and healthcare policy makers should consider these factors during decision-making coverage of (complete) antenatal steroid therapy, early diagnosis and treatment of PDA with paracetamol/ibuprofen, delayed cord clamping in labour room to prevent hypotension hence, use of inotropes and boluses can prevent GM-IVH in preterms.