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Original research
School-age outcomes following intraventricular haemorrhage in infants born extremely preterm
  1. Nicky Laura Hollebrandse1,
  2. Alicia J Spittle2,3,4,
  3. Alice C Burnett3,5,6,7,
  4. Peter J Anderson3,8,
  5. Gehan Roberts6,9,
  6. Lex W Doyle3,5,6,10,
  7. Jeanie Ling Yoong Cheong2,3,10
  1. 1Faculty of Medical Sciences, Rijksuniversiteit Groningen, Groningen, The Netherlands
  2. 2Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia
  3. 3Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  4. 4Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
  5. 5Premature Infant Follow-Up Program, The Royal Women's Hospital, Parkville, Victoria, Australia
  6. 6Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
  7. 7Neonatal Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
  8. 8Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
  9. 9Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  10. 10Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Professor Jeanie Ling Yoong Cheong, Neonatal Services, Royal Women's Hospital, Parkville, VIC 3052, Australia; jeanie.cheong{at}thewomens.org.au

Abstract

Objective To determine the associations of different grades of intraventricular haemorrhage (IVH), particularly grades 1 and 2, with neurodevelopmental outcomes at 8 years of age in children born extremely preterm.

Design Population-based cohort study.

Setting State of Victoria, Australia.

Patients Survivors born at <28 weeks’ gestational age (n=546) and matched term-born controls (n=679) from three distinct eras, namely, those born in 1991–1992, 1997 and 2005.

Exposure Worst grade of IVH detected on serial neonatal cranial ultrasound.

Outcome measures Intellectual ability, executive function, academic skills, cerebral palsy and motor function at 8 years.

Results There was a trend for increased motor dysfunction with increasing severity of all grades of IVH, from 24% with no IVH, rising to 92% with grade 4 IVH. Children with grade 1 or 2 IVH were at higher risk of developing cerebral palsy than those without IVH (OR 2.24, 95% CI 1.21 to 4.16). Increased rates of impairment in intellectual ability and academic skills were observed with higher grades of IVH, but not for grade 1 and 2 IVH. Parent-rated executive functioning was not related to IVH.

Conclusion While low-grade IVH is generally considered benign, it was associated with higher rates of cerebral palsy in school-aged children born EP, but not with intellectual ability, executive function, academic skills or overall motor function. Higher grades of IVH were associated with higher rates and risks of impairment in motor function, intellectual ability and some academic skills, but not parental ratings of executive function.

  • epidemiology
  • child psychology
  • neonatology
  • neurodevelopment
  • neurodisability

https://doi.org/10.1136/archdischild-2020-318989

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    Footnotes

    • Contributors NLH conceptualised and designed the study, conducted the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript; AJS conceptualised and designed the study, contributed to data analyses and critically reviewed the manuscript; GR, ACB and PJA contributed to interpretation of data and critical revisions of the manuscript; LWD and JLYC conceptualised and designed the study, designed the data collection and study protocol, coordinated and supervised data collection, contributed to data analyses and critically reviewed the manuscript.

    • Funding Funded by grants from the National Health and Medical Council (project grant ID 284512; Career Development Fellowship ID 1141354 to JLYC, ID 1108714 to AJS; Senior Research Fellowship ID 1081288 to PJA; Centre of Research Excellence ID 1060733) and the Victorian Government’s Operational Infrastructure Support Programme.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available. Data are not in a repository. It is deidentified participant data, and the data custodian will be me (ORCID: 0000-0001-5901-0455). No protocol is published, and the statistical analysis plan is in the methods of the paper.

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