Roberts Jonathan C, Javed M Jawad, Hocker James R, Wang Huaping, Tarantino Michael D
Bleeding & Clotting Disorders Institute.
University of Illinois College of Medicine at Peoria, Department of Pediatrics.
Blood Coagul Fibrinolysis. 2018 Jan;29(1):25-29. doi: 10.1097/MBC.0000000000000661.
: Intraventricular hemorrhage (IVH) is a significant cause of morbidity in extremely premature infants despite many advances in neonatal intensive care. We conducted an institutional retrospective review aimed to correlate risk factors associated with IVH. Clinical variables reported to the Vermont-Oxford Network on less than 30 weeks gestational age infants over a 5-year period were evaluated with Pearson's chi-square and multivariate logistic regression. Of 618 infants born less than 30-week gestational age, 178 (28.8%) experienced IVH. Of those less than 1000 g, 105 (36.5%) of 288 infants experienced IVH. Multivariate analysis revealed that thrombocytopenia [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.30-3.19, P = 0.0020] and cardiopulmonary resuscitation (CPR) ± intubation at delivery (OR 1.84, 95% CI 1.12-3.02, P = 0.0162) were independently associated with IVH. Among infants less than 1000 g, thrombocytopenia (OR 2.09, 95% CI 1.22-3.60, P = 0.0077) and CPR ± intubation at delivery (OR 2.01, 95% CI 1.10-3.68, P = 0.0229) were also significantly associated with IVH. IVH is a complex phenomenon with many contributing risk factors. In our study, infants less than 30-week gestational age and less than 1000 g revealed thrombocytopenia and CPR ± intubation in delivery room were independently associated with IVH. These data should alert clinicians to those neonates most likely to suffer IVH.
尽管新生儿重症监护取得了许多进展，但脑室内出血（IVH）仍是极早产儿发病的重要原因。我们进行了一项机构回顾性研究，旨在关联与IVH相关的危险因素。对向佛蒙特-牛津网络报告的5年内胎龄小于30周婴儿的临床变量进行了Pearson卡方检验和多因素逻辑回归分析。在618例胎龄小于30周出生的婴儿中，178例（28.8%）发生了IVH。在体重小于1000g的婴儿中，288例中有105例（36.5%）发生了IVH。多因素分析显示，血小板减少症[比值比（OR）2.03，95%置信区间（CI）1.30 - 3.19，P = 0.0020]和分娩时心肺复苏（CPR）±插管（OR 1.84，95% CI 1.12 - 3.02，P = 0.0162）与IVH独立相关。在体重小于1000g的婴儿中，血小板减少症（OR 2.09，95% CI 1.22 - 3.60，P = 0.0077）和分娩时CPR±插管（OR 2.01，95% CI 1.10 - 3.68，P = 0.0229）也与IVH显著相关。IVH是一种具有多种促成危险因素的复杂现象。在我们的研究中，胎龄小于30周且体重小于1000g的婴儿，血小板减少症以及分娩室中的CPR±插管与IVH独立相关。这些数据应提醒临床医生注意那些最有可能发生IVH的新生儿。
