Original articleGrades I-II intraventricular hemorrhage in extremely low birth weight infants: Effects on neurodevelopment
Section snippets
Methods
Seven hundred six ELBW infants without major congenital malformations were admitted to the neonatal intensive care unit at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, from January 1, 1992, through December 31, 2000. Five hundred thirty-seven survived to 20 months’ CA and had cranial ultrasound studies performed during the hospital course, of whom 490 (91%) had complete neurodevelopmental assessments at that time. The protocol for cranial ultrasound screening of ELBW infants
Results
A comparison of maternal sociodemographic data and perinatal and neonatal risk factors between infants with a normal cranial ultrasound and those with grade I-II IVH is given in Table I. Significantly more mothers of infants with grade I-II IVH were unmarried and black compared with mothers of infants with a normal cranial ultrasound. The mothers of infants with grades I-II IVH also had lower rates of antenatal steroid therapy and delivery by cesarean section. Infants with grade I-II IVH had
Discussion
Our study indicates that ELBW infants born since 1992 with grades I-II IVH have significantly poorer neurodevelopmental outcomes at 20 months’ CA compared with ELBW infants with a normal cranial ultrasound, even after adjusting for confounding factors. Poorer outcomes included higher rates of major neurologic abnormality and deafness and poorer cognitive development, as evidenced by lower mean MDI scores and higher rates of subnormal MDI.
Most studies that have examined the effects of grades
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Supported by grant M01 RR00080, General Clinical Research Center of the National Institutes of Health.