Outcomes of extremely preterm infants following severe intracranial hemorrhage

A. S. Davis, S. R. Hintz, R. F. Goldstein, N. Ambalavanan, C. M. Bann, B. J. Stoll, E. F. Bell, S. Shankaran, A. R. Laptook, M. C. Walsh, E. C. Hale, N. S. Newman, A. Das, R. D. Higgins

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Objective:Severe intracranial hemorrhage (ICH) is an important prognostic variable in extremely preterm (EPT) infants. We examined imaging and clinical variables that predict outcomes in EPT infants with severe ICH.Study design:Retrospective analysis of 353 EPT infants with severe ICH. Outcomes were compared by examining: (i) unilateral vs bilateral ICH; and (ii) presence vs absence of hemorrhagic parenchymal infarction (HPI). Regression analyses identified variables associated with death or neurodevelopmental impairment (NDI).Result:Bilateral ICH and HPI had higher rates of adverse outcomes and were independently associated with death/NDI. HPI was the most important variable for infants of lower birth weight, and bilateral ICH for larger infants. For infants surviving to 36 weeks, shunt placement was most associated with death/NDI.Conclusion:Bilateral ICH and the presence of HPI in EPT infants with severe ICH are associated with death/NDI, though the importance depends on birth weight and survival to 36 weeks.

Original languageEnglish
Pages (from-to)203-208
Number of pages6
JournalJournal of Perinatology
Issue number3
StatePublished - Mar 2014

Bibliographical note

Funding Information:
We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. Investigators, in addition to those listed as authors, who participated in this study are listed in the Appendix. The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development provided grant support for the Neonatal Research Network’s Generic Database Study and Follow-up Study.


  • cranial ultrasound
  • extremely low birth weight
  • intraventricular hemorrhage
  • neurodevelopmental impairment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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