Factors associated with early severe intraventricular haemorrhage in very low birth weight infants.

OBJECTIVE

The aim of this study was to identify factors associated with early IVH grades III-IV in the first 72 h of life in very low birth weight (VLBW) preterm infants.

METHODS

A case-control study was performed in 28 preterm infants and 55 controls. The mean of all blood gas determinations, presence of arterial hypotension, variables related to mechanical ventilation, as well as antenatal and neonatal comorbidities during the first 3 days of life were evaluated.

RESULTS

The proportion of infants with pH<7.2, PaCO (2) >55 mmHg and arterial hypotension was higher in the case group. PaCO (2) >55 mmHg was more frequently found in patients with IVH grades III (16.6 vs. 1.8%; p=0.03) and IV (37.5 vs. 1.8%; p=0.0001) than in controls, respectively. Gestational age (beta=-0.30; p=0.04), BE (beta=0.33; p=0.0005) and arterial hypotension (beta=0.40; p=0.00003) were associated to both grades of IVH (R (2)=0.39; p<0.0001 for the model). However, only birth weight and arterial hypotension were identified as factors related to IVH grade III (R (2)=0.44; p=0.0001 for the model) and PaCO (2) >55 mmHg, and BE as factors for IVH grade IV (R (2)=0.32; p=0.0003 for the model).

CONCLUSION

Birth weight and arterial hypotension were factors related to early IVH grade III, whereas hypercapnia and large BE were factors related to IVH grade IV in VLBW infants.