Elsevier

Placenta

Volume 21, Issue 4, May 2000, Pages 402-407
Placenta

Regular Article
Risk Factors for Neonatal Intraventricular Haemorrhage in Spontaneous Prematurity at 32 Weeks Gestation or Less

https://doi.org/10.1053/plac.1999.0499Get rights and content

Abstract

In this study we aimed to establish which clinical and histopathological factors are associated with early-onset neonatal intraventricular haemorrhage (IVH) in non-iatrogenic preterm delivery before 32 weeks of gestation.

We retrospectively reviewed all singleton pregnancies delivered before 32 weeks of gestation after spontaneous onset of preterm labour or preterm membrane rupture during the period January 1993 to June 1997. Clinical and histopathological data in cases with IVH diagnosed at neonatal cranial ultrasound within 72 h of birth (n=17) were compared with those of neonates not experiencing this complication (non-IVH) (n=54). Histological lesions analysed were those of acute inflammation and those on a uteroplacental vascular basis. Statistical methods included the Wilcoxon rank sum test, Fisher's exact test, and logistic regression analysis. A P< 0.05 was considered significant.

IVH and non-IVH groups were not significantly different in birthweight, gestational age at delivery, cord pH at birth, rates of 5-min Apgar score below 7, caesarean delivery, diagnosis of clinical chorioamnionitis or antenatal administration of steroids. Respiratory distress syndrome was more frequently diagnosed in the IVH than non-IVH group (64 per cent versus 33 per cent, P=0.02). Placental acute inflammatory or uteroplacental vascular lesions were present in 100 per cent of IVH neonates versus 22 per cent of non-IVH cases (P< 0.001). Logistic regression analysis demonstrated that only respiratory distress syndrome (P=0.04) and histological evidence of acute placental inflammation (P=0.02) were significantly and independently associated with IVH.

Histopathological evidence of acute inflammatory placental lesions is the best predictor of occurrence of neonatal IVH.

References (28)

Cited by (62)

  • Risk Factors for Intraventricular Hemorrhage in Preterm Infants Born at 34 Weeks of Gestation or Less Following Preterm Premature Rupture of Membranes

    2016, Journal of Stroke and Cerebrovascular Diseases
    Citation Excerpt :

    In the present study, significant risk factors associated with IVH in preterm infants following pPROM included lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis. Lower gestational age and low birth weight are identified as the main causes of IVH occurrence in premature infants.12-14 In the present study, the mean birth weight of infants with IVH was 986 ± 122 g and the mean gestation was 29.3 ± 2.8 weeks.

  • Patterns of placental pathology in preterm infants with a periventricular haemorrhagic infarction: Association with time of onset and clinical presentation

    2012, Placenta
    Citation Excerpt :

    This might emphasize the importance of placental lesions and a coinciding systemic response in the newborn with consequences for the neonatal brain. Several studies have focused on the role of placental lesions in preterm brain injury, including IVH [8,9]. Most of these studies included small numbers of infants with PVHI (IVH grade IV) or focused on histological chorioamnionitis only [10–14].

  • Repetitive cerebrospinal fluid flushing in a preterm newborn with posthaemorrhagic hydrocephalus. Technical note and review of literature

    2012, Clinical Neurology and Neurosurgery
    Citation Excerpt :

    Different risk factors have been associated with intraventricular haemorrhage. The major risk factors are low birth weight and low gestational age followed by prolonged labor, postnatal resuscitation and intubation, development of respiratory distress syndrome, metabolic acidosis and high-frequency ventilation, intrauterine infection and postnatal sepsis [4,5,15–18]. The ventricular haemorrhage in preterm neonates is graded according to the Papile scale from grade I to grade IV.

View all citing articles on Scopus
f1

To whom correspondence should be addressed at: Divisione di Ostetricia e Ginecologia, I.S.B.M. San Gerardo, Via Solferino, 16, 20052 Monza, Italy. Fax: +39-039 233 3820; E-mail:[email protected]

View full text