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Editorial
Intraventricular haemorrhage in preterm children: viewing longer term with a wider lens
  1. Noha Gomaa1,
  2. Steven P Miller2
  1. 1Neurosciences and Mental Health, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Steven P Miller, Department of Paediatrics, Division of Neurology, The Hospital for Sick Children (SickKids), Toronto, ON M5G 1X8, Canada; steven.miller{at}sickkids.ca

https://doi.org/10.1136/archdischild-2020-319983

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    Despite significant advances in perinatal and neonatal care, intraventricular haemorrhage (IVH)—bleeding from blood vessels within the germinal matrix of the developing brain into the ventricular system—continues to affect 15%–20% of very preterm neonates and 45% of those born extremely preterm (EP).1 More than half of very preterm neonates will exhibit neurodevelopmental challenges as a consequence of IVH that range widely in severity across motor and cognitive domains.2 Such disabilities place a significant toll on affected children and their families, as well as on the education and healthcare system, highlighting the need for timely interventions in the neonatal intensive care unit (NICU) and beyond.

    The study reported by Hollebrandse et al3 assesses the relationship between IVH and neurodevelopmental outcomes at 8 years of age in children born EP, using a population-based sample of 546 EP neonates and 679 matched term-born controls. This cohort is distinguished by remarkably high follow-up rates from three different timepoints. In their study, Hollebrandse et al raise three critical issues in the investigation of the impact of IVH on neurodevelopmental outcomes. First is the importance of the age at which neurodevelopmental assessment occurs and its implications to understanding the long-term impacts of IVH. Second is the extent to which different grades of IVH contribute to the spectrum of neurodevelopmental outcomes. Third is identifying interventions within NICU practice and postdischarge that can help mitigate the adverse impacts of IVH with attention to the timepoints at which these therapies are most supportive of neurodevelopmental outcomes.

    The age at which neurodevelopmental …

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    Footnotes

    • Twitter @noha_gm

    • Contributors NG drafted the initial editorial and approved the final editorial as submitted. SPM reviewed and revised the editorial and approved the final editorial as submitted.

    • Funding SPM is supported by the Bloorview Children’s Hospital Chair in Paediatric Neuroscience. NG is supported by the Ontario Brain Institute and a Restracomp Fellowship at SickKids Research Institute.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; externally peer reviewed.

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