Intraventricular Hemorrhage and Developmental Outcomes at 24 Months of Age in Extremely Preterm Infants

Author:

O’Shea T. Michael1,Allred Elizabeth N.234,Kuban Karl C. K.5,Hirtz Deborah6,Specter Barbara1,Durfee Sara2,Paneth Nigel7,Leviton Alan24

Affiliation:

1. Wake Forest School of Medicine, Winston-Salem, NC, USA

2. Harvard Medical School, Boston, MA, USA

3. Harvard School of Public Health, Boston, MA, USA

4. Children’s Hospital, Boston, MA, USA

5. Department of Pediatrics, Boston Medical Center, Boston, MA, USA

6. National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA

7. Michigan State University, East Lansing, MI, USA

Abstract

Whether intraventricular hemorrhage increases the risk of adverse developmental outcome among premature infants is controversial. Using brain ultrasound, we identified intraventricular hemorrhage and white matter abnormalities among 1064 infants born before 28 weeks’ gestation. We identified adverse developmental outcomes at 24 months of age using a standardized neurologic examination and the Bayley Scales of Infant Development Mental and Motor Scales. In logistic regression models that adjusted for gestational age, sex, and public insurance, isolated intraventricular hemorrhage was associated with visual fixation difficulty but no other adverse outcome. Infants who had a white matter lesion unaccompanied by intraventricular hemorrhage were at increased risk of cerebral palsy, low Mental and Motor Scores, and visual and hearing impairments. Except when accompanied or followed by a white matter lesion, intraventricular hemorrhage is associated with no more than a modest increase (and possibly no increase) in the risk of adverse developmental outcome during infancy.

Publisher

SAGE Publications

Subject

Neurology (clinical),Pediatrics, Perinatology and Child Health

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