Ghaderi Mobin, Afraie Maryam, Pourahmad Bita, Amirimanesh Nona, Rahimi Artin, Sheikhahmadi Shobo, Moradi Yousef
Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Eur J Med Res. 2025 Aug 1;30(1):695. doi: 10.1186/s40001-025-02960-2.
Intraventricular hemorrhage (IVH) is a major cause of morbidity and mortality among preterm neonates, making early identification of risk factors critical to improving outcomes. Understanding both clinical conditions and therapeutic interventions associated with IVH can guide prevention and management strategies.
A systematic review and meta-analysis were conducted, incorporating 30 studies that investigated various risk factors for IVH. The studies were categorized based on the clinical conditions and therapeutic interventions involved. The data were analyzed using pooled relative risks (RR) and heterogeneity assessments, including I values and P-values.
The analysis revealed several significant clinical risk factors for IVH. Male gender was associated with a 15% increased risk of IVH (pooled RR: 1.15, 95% CI 1.00-1.32), while low birth weight (< 1000g) was linked to a 94% increased risk (pooled RR: 1.94, 95% CI 1.38-2.73). Other significant factors included the presence of Apgar ≤ 5 or 7 (pooled RR: 2.14, 95% CI 1.69-2.72), asphyxia (pooled RR: 1.70, 95% CI 1.26-2.28), and thrombocytopenia (pooled RR: 1.34, 95% CI 1.10-1.62). Neonatal conditions such as respiratory distress syndrome (RDS) and hyaline membrane disease (HMD) were also found to increase IVH risk significantly. In terms of therapeutic interventions, antenatal steroids were associated with a reduced risk of IVH (pooled RR: 0.79, 95% CI 0.70-0.89), while mechanical ventilation, the use of catecholamines, surfactant administration increased IVH risk significantly (pooled RR for mechanical ventilation: 3.27, 95% CI 2.77-3.86; pooled RR for surfactant: 2.32, 95% CI 1.61-3.35).
Several clinical factors and therapeutic interventions are associated with the risk of IVH in neonates. These findings emphasize the importance of early identification and management of high-risk neonates, as well as the need for further research to refine prevention strategies.
脑室内出血（IVH）是早产新生儿发病和死亡的主要原因，因此早期识别风险因素对于改善预后至关重要。了解与IVH相关的临床情况和治疗干预措施可以指导预防和管理策略。
进行了一项系统综述和荟萃分析，纳入了30项研究，这些研究调查了IVH的各种风险因素。这些研究根据所涉及的临床情况和治疗干预措施进行分类。使用合并相对风险（RR）和异质性评估（包括I值和P值）对数据进行分析。
分析揭示了IVH的几个重要临床风险因素。男性性别与IVH风险增加15%相关（合并RR：1.15，95%CI 1.00-1.32），而低出生体重（<1000g）与风险增加94%相关（合并RR：1.94，95%CI 1.38-2.73）。其他重要因素包括阿氏评分≤5或7（合并RR：2.14，95%CI 1.69-2.72）、窒息（合并RR：1.70，95%CI 1.26-2.28）和血小板减少症（合并RR：1.34，95%CI 1.10-1.62）。还发现新生儿疾病如呼吸窘迫综合征（RDS）和透明膜病（HMD）也会显著增加IVH风险。在治疗干预方面，产前使用类固醇与IVH风险降低相关（合并RR：0.79，95%CI 0.70-0.89），而机械通气、使用儿茶酚胺、给予表面活性剂会显著增加IVH风险（机械通气的合并RR：3.27，95%CI 2.77-3.86；表面活性剂的合并RR：2.32，95%CI 1.61-3.35）。
几个临床因素和治疗干预措施与新生儿IVH风险相关。这些发现强调了早期识别和管理高危新生儿的重要性，以及进一步研究以完善预防策略的必要性。
