Incidence Trends and Risk Factor Variation in Severe Intraventricular Hemorrhage across a Population Based Cohort

The Journal of Pediatrics
Sara C HandleyScott A Lorch

Abstract

To quantify the current burden of severe intraventricular hemorrhage (IVH), describe time trends in severe IVH, identify IVH-associated risk factors, and determine the contribution of mediating factors. The retrospective cohort included infants 220/7-316/7 weeks of gestation without severe congenital anomalies, born at hospitals in the California Perinatal Quality Care Collaborative between 2005 and 2015. The primary study outcome was severe (grade III or IV) IVH. Of 44 028 infants, 3371 (7.7%) had severe IVH. The incidence of severe IVH decreased significantly across California from 9.7% in 2005 to 5.9% in 2015. After stratification by gestational age, antenatal steroid exposure was the only factor associated with a decreased odds of severe IVH for all gestational age subgroups. Other factors, including delivery room intubation, were associated with an increased odds of severe IVH, though significance varied by gestational age. Factors analyzed in the mediation analysis accounted for 45.6% (95% CI 38.7%-71.8%) of the reduction in severe IVH, with increased antenatal steroid administration and decreased delivery room intubation mediating a significant proportion of this decrease, 19.4% (95% CI 13.9%-27.5%) and 27.3% (95% CI 20....Continue Reading

References

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Citations

Oct 5, 2018·Developmental Medicine and Child Neurology·Brigitte Vollmer
Jun 16, 2019·Archives of Disease in Childhood. Fetal and Neonatal Edition·Kee Thai YeoUNKNOWN Australian and New Zealand Neonatal Network
Oct 4, 2020·International Journal of Molecular Sciences·Amanda KristianssonJill R Storry
Jun 27, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Gia YannekisScott Lorch
Sep 15, 2020·Journal of Neonatal-perinatal Medicine·J J Volpe
Jul 12, 2019·Frontiers in Physiology·Eduardo Villamor-MartinezEduardo Villamor
Dec 7, 2018·Journal of Perinatology : Official Journal of the California Perinatal Association·Sara C HandleyHenry C Lee
Jul 20, 2020·Fluids and Barriers of the CNS·Jacob GluskiCarolyn A Harris
Dec 1, 2020·Developmental Medicine and Child Neurology·Nadia BadawiRod W Hunt
Oct 16, 2020·The Journal of Pediatrics·Satoshi KusudaUNKNOWN Neonatal Research Network of Japan and the California Perinatal Quality Care Collaborative
Apr 6, 2021·International Journal of Pediatrics·Walufu Ivan EgesaPatrick Kumbowi Kumbakulu
Jul 5, 2021·The Journal of Pediatrics·Janessa B LawSandra E Juul
Sep 2, 2021·Seminars in Perinatology·S J Steggerda, L S de Vries
Oct 28, 2020·Pediatrics·Ivan L HandUNKNOWN COMMITTEE ON FETUS AND NEWBORN, SECTION ON NEUROLOGY, SECTION ON RADIOLOGY

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