van de Bor M, Verloove-Vanhorick S P, Brand R, Keirse M J, Ruys J H
Department of Pediatrics, University Hospital Leiden, The Netherlands.
J Perinat Med. 1987;15(4):333-9. doi: 10.1515/jpme.1987.15.4.333.
During a prospective national survey of mortality and morbidity in infants born before 32 weeks gestation in the Netherlands in 1983, the incidence of periventricular-intraventricular hemorrhage (PIVH) was studied with ultrasound, in 484 of those infants. Stepwise logistic regression analyses were used to examine the predictive value of several maternal, prenatal and postnatal factors for the development of neonatal PIVH. PIVH was detected in 140 infants (28.9%); of these, 36 were grade I, 39 grade II, 22 grade III and 43 grade IV. The mortality rate increased from 3 to 84% with increasing severity of PIVH. Gestational age appeared to be the strongest predictive factor for both incidence and severity of PIVH, followed by idiopathic respiratory distress syndrome (IRDS), prolonged rupture of membranes and birth weight. Of the maternal and prenatal factors studied, only prolonged rupture of membranes (greater than 24 hours) and preeclampsia appeared to influence the risk of developing PIVH. Both were associated with a 50% reduction in the incidence of PIVH. None of the intrapartum factors studied showed a significant association with subsequent development of PIVH. Development of IRDS appeared to result in a twofold increase in the incidence of PIVH.
在1983年荷兰进行的一项针对孕周小于32周的早产婴儿死亡率和发病率的前瞻性全国性调查中，对484例此类婴儿进行超声检查，研究脑室周围-脑室内出血（PIVH）的发生率。采用逐步逻辑回归分析来检验若干母体、产前和产后因素对新生儿PIVH发生的预测价值。140例婴儿（28.9%）检测到PIVH；其中，I级36例，II级39例，III级22例，IV级43例。随着PIVH严重程度的增加，死亡率从3%升至84%。胎龄似乎是PIVH发生率和严重程度的最强预测因素，其次是特发性呼吸窘迫综合征（IRDS）、胎膜早破和出生体重。在所研究的母体和产前因素中，只有胎膜早破（超过24小时）和先兆子痫似乎会影响发生PIVH的风险。两者均与PIVH发生率降低50%相关。所研究的产时因素均未显示与随后发生PIVH有显著关联。IRDS的发生似乎会使PIVH发生率增加两倍。
