2010, Number 6
<< Back Next >>
Gac Med Mex 2010; 146 (6)
Evaluación de factores prenatales, perinatales y posnatales para hemorragia intraventricular en prematuros menores de 33 semanas de edad gestacional
Caro-López AM, Barrera-de León JC, Domínguez-Sánchez H, Alejandrina-Castillo SR, Higareda-Almaraz MA
Language: Spanish
References: 25
Page: 376-382
PDF size: 85.85 Kb.
ABSTRACT
Objective: Evaluation of risk factors for intraventricular hemorrhage in preterm less than 33 weeks gestational age (RNP).
Methods: Case-control study. We included RNP from a tertiary care center, classified by the results of transfontanellar sonography. Case: presence of intraventricular hemorrhage. Control: absence of intraventricular hemorrhage. We investigated prenatal history, perinatal and postnatal. Logistic regression was used to adjust the variables associated with intraventricular hemorrhage; we calculated odds ratios (OR) with confidence intervals of 95% (95% CI).
Results: We analyzed the medical records of RNP 64; of these 32 were cases. The risk factors associated with intraventricular hemorrhage were: sepsis (OR: 18.45; 95% CI: 4.01-32.82; p = 0.01), respiratory distress syndrome (OR: 2.24; 95% CI: 1.07-4.95; p = 0.04), use with mechanical ventilation (OR: 3.60; 95% CI: 1.46-8.91; p = 0.01), and exogenous surfactant (OR: 2.32; 95% CI: 1.05-6.14; p = 0.03).
Conclusions: The postnatal factors were associated with higher risk for intraventricular hemorrhage in RNP. The transfontanellar sonography should be taken at different times to know with precision the risk factors for this pathology and try to avoid them.
REFERENCES
Synnes AR, Chien LY, Peliowsk A, et al. Variations in intraventricular hemorrhage incidence rates among Canadian neonatal intensive care units. J Pediatr. 2001;138:525-31.
Lee JY, Kim HS, Jung E, et al. Risk factors for periventricular-intraventricular hemorrhage in premature infants. J Korean Med Sci. 2010; 25:418-24.
Locatelli A, Andreani M, Pizzardi A, Paterlini G, Stoppa P, Ghidini A. Antenatal variables associated with severe adverse neurodevelopmental outcome among neonates born at less than 32 weeks. Eur J Obstet Gynecol Reprod Biol. 2010 Jun 23. [Epub ahead of print]
Perlman JM, McMenamin JB, Volpe JJ. Fluctuating cerebral blood-flow velocity in respiratory distrss syndrome. Relation to the development of intraventricular hemorrhage. N Engl J Med. 1983;309:204-9.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92:529-34.
Maalouf EF, Duggan PJ, Counsell SJ, et al. Comparison of findings on cranial ultrasound and magnetic resonance imagin in preterm infants. Pediatrics. 2001;107:719-27.
Spinillo A, Ometto A, Stronati M, Piazzi G, Lasci A, Rondini G. Epidemiologic association between maternal smoking during pregnancy and intracranial hemorrhage in preterm infants. J Pediatr. 1995;127:472-8.
Verma U, Tejani N, Klein S, et al. Obstetric antecedents of intraventricular hemorrhage an periventricular leukomalacia in the low-birth-weight neonato. Am J Obstet Gynecol. 1997;76:275-81.
Hansen A, Leviton A. Labor an delivery characteristics and risk of cranial ultrasonographic abnormalities among very-low-birth-weight infants. Am J Obstet Gynecol. 1999;181:997-1006.
Alexander JM, Gilstrap LC, Cox Sm, Mclntire DM, Leveno KJ. Clinical chorioamnionitis and the prognosis for very low birth weight infants. Obstet Gynecol. 1998;91:725-9.
Wells JT, Ment LR. Prevention of intraventricular hemorrhage in preterm infants. Early Hum Dev. 1995;42:209-33.
Gleissner M, Jorch G, Avenarius S. Risk factors for intraventricular hemorrhage in a birt cohort of 3721 premature infants. J Perinat Med. 2000;28:104-10.
Volpe JJ. Intraventricular hemorrhage in the premature infant: current concepts part II. Ann Neurol. 1989;25:109-16.
Synnes AR, Chien LY, Peliowaki A, et al. Variations in intraventricular hemorrhage incidence rates among. Canadian neonatal intensive care units. J Pediatr. 2001;138:525-31.
Linder N, Haskin O, Levit O, et al. Risk factors for intraventricular hemorrhage in very low birth weight premature infants: a retrospective case-control study. Pediatrics. 2003;111:590-5.
Cools F, Offringa M. Meta-analysis of elective high frequency ventilation in preterm infants with respiratory distress syndrome. Arch Dis Fetal Neonatal. 1999;80:15-20.
Kusuda S, Fujimura M, Sakuma I, et al. Morbidity and mortality of infants with very low birth weight in Japan: Center variation. Pediatrics. 2006; 118:1130-8.
Weinstein L. Syndrome of hemolysis, elevated enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol. 1982;142:159-67.
Ballard JL, Khoury JC, Wedig K, et al. New Ballard Score. Expandended to include premature infants. J Pediatr. 1991;119:417.
Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2010 update. Neonatology. 2010;97:402-17.
Kuhns LR, Bednarek FJ, Wyman ML, Roloff DW, Borer RC. Diagnosis of pneumothorax or pneumomediastinum in the neonate by transillumination. Pediatrics. 1975;56:355-60.
Goldstein B, Giroir B, Randolph A. International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6:2-8.
World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Nurs Ethics. 2002;9(1):105-9.
Vela-Huerta MM, Amador-Licona M, Medina-Ovando N, Aldana-Valenzuela C. Factors associated with early severe intraventricular haemorrhage in very low birth weight infants. Europediatrics. 2009; 40(5):224-7.
Cowan F, Whitelaw A, Wertheim D, Silverman M. Cerebral blood flow velocity changes after rapid administration of surfactant. Arch Dis Child. 1991;66(10 Spec N.o):1105-9.