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

doi:10.1038/jp.2013.162

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

Pediatrics

Research output: Contribution to journal › Article › peer-review

49 Scopus citations

Abstract

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 language	English
Pages (from-to)	203-208
Number of pages	6
Journal	Journal of Perinatology
Volume	34
Issue number	3
DOIs	https://doi.org/10.1038/jp.2013.162
State	Published - 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.

Keywords

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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10.1038/jp.2013.162

Cite this

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title = "Outcomes of extremely preterm infants following severe intracranial hemorrhage",

abstract = "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.",

keywords = "cranial ultrasound, extremely low birth weight, intraventricular hemorrhage, neurodevelopmental impairment",

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

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{\textquoteright}s Generic Database Study and Follow-up Study.",

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doi = "10.1038/jp.2013.162",

language = "English",

volume = "34",

pages = "203--208",

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AU - Davis, A. S.

AU - Hintz, S. R.

AU - Goldstein, R. F.

AU - Ambalavanan, N.

AU - Bann, C. M.

AU - Stoll, B. J.

AU - Bell, E. F.

AU - Shankaran, S.

AU - Laptook, A. R.

AU - Walsh, M. C.

AU - Hale, E. C.

AU - Newman, N. S.

AU - Das, A.

AU - Higgins, R. D.

N1 - 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.

PY - 2014/3

Y1 - 2014/3

N2 - 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.

AB - 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.

KW - cranial ultrasound

KW - extremely low birth weight

KW - intraventricular hemorrhage

KW - neurodevelopmental impairment

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Outcomes of extremely preterm infants following severe intracranial hemorrhage

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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