Original ArticlesIntubation Attempts Increase the Risk for Severe Intraventricular Hemorrhage in Preterm Infants—A Retrospective Cohort Study
Section snippets
Methods
This was a retrospective cohort analysis of a prospectively collected database of inborn, VLBW, infants who were intubated in the first 4 days after birth and admitted to the neonatal intensive care unit (NICU) at the University of California, San Diego, between January 1, 2005, and July 30, 2009. The population was chosen because 90% of IVH occurs within the first 4 days after birth and 50% occurs within 24 hours after birth.8 Infants with any known grade of IVH before the first intubation
Results
A total of 308 VLBW infants (mean gestational age 26.9± 2.2 weeks) were intubated during the first 4 days after birth, including 102 infants with a BW of less than 750 g (mean gestational age 25.1 ± 1.7 weeks). Antenatal steroids were administered to more than 90% of the mothers in both groups. Demographic data are shown in Table I, and the results for risk factors significantly associated with severe IVH used for the multivariable analysis are shown in Table II.
A total of 188 infants were
Discussion
In this retrospective cohort study of VLBW infants, we found significant associations in 2 high-risk groups of infants: those with BW <750 g and VLBW infants who were only intubated in the DR. Infants with BW <750 g who had more than 3 intubation attempts were nearly 28 times more likely to have severe IVH. It was shown previously that lower BW and earlier gestational age increased the risk of IVH.9 This study supports the conclusion that extremely preterm infants are more sensitive to the
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Funded by University of California, San Diego. The authors declare no conflicts of interest.