Neurodevelopmental outcome of preterm infants with isolated grade I intraventricular hemorrhage: a matched case-control study : /

Abstract

Background: Germinal matrix and intraventricular hemorrhages remain one of the most common complications along preterm infants, detected by cranial ultrasound. Especially the impact of low-grade intraventricular hemorrhages on neurodevelopmental outcome has been the source of debate.

Objective: To determine the neurodevelopmental outcome of preterm infants (≤32 weeks) with isolated grade I intraventricular hemorrhage at 24 (19-30) month’s corrected age.

Methods: A single-center matched case-control study of preterm infants born at ≤32 weeks’ gestation between January 1, 2011 and December 31, 2016 and diagnosed with an isolated grade I intraventricular hemorrhage on cranial ultrasound. Cases were matched with their corresponding control (without intraventricular hemorrhage) based on gestational age (same week), birth weight (±250g), sex and year of birth (born within 2 years after birth of the corresponding case). Neurodevelopmental outcomes were compared at 24 (19-30) months’ corrected age.

Results: The final study cohort consisted of 52 cases and 52 matched controls. Sixty-six point three percent of eligible survivors completed follow-up. Infants with grade I intraventricular hemorrhage had significantly lower mean psychomotor developmental index (PDI) scores and a higher rate of motor delay (PDI <85) than those without intraventricular hemorrhage. Furthermore, significantly less preterm infants with grade I intraventricular hemorrhage received antenatal corticosteroids and were inborn, while vaginal delivery occurred significantly more in the grade I intraventricular hemorrhage group.

Conclusions: At 19-30 month’s corrected age, preterm infants with isolated grade I intraventricular hemorrhage had a significantly poorer motor outcome than their matched controls with normal cranial ultrasound.