Prevalence and epidemiological characteristics of intraventricular hemorrhage in low birth weight newborns in intensive care

Abstract

Objective: To determine the prevalence of intraventricular haemorrhage in very low birth weight infants and its main epidemiological characteristics.

Materials and Methods: Observational, retrospective, descriptive and cross-sectional study, with non-probabilistic sampling of consecutive cases for convenience. The records of 86 preterm infants weighing less than 1,500 grams during the period from January 2010 to December 2020 were reviewed, including only those with a diagnosis of intraventricular hemorrhage at discharge from the Neonatal Intensive Care Unit. Classification was performed by transfontanelar ultrasonography according to the Papile scale.

Results: A total of 16 cases of intraventricular hemorrhage (18.6% prevalence) were identified, with a mean stay of 76 days. The mean gestational age was 29 weeks and a weight of 1,072 grams. The distribution by severity showed: grade I 19%, grade II 6%, grade III 56% and grade IV 19%. The predominant clinical presentation was saltatory (50%), followed by catastrophic (31%) and silent (19%). There was no significant predominance of sex. The main postnatal risk factors identified were: apnea, respiratory distress syndrome, elevated C-reactive protein and surfactant use (94%), invasive ventilation and hypercapnia (87%). No cases of post-hemorrhagic hydrocephalus were reported as a complication.

Conclusions: The prevalence of intraventricular hemorrhage was 18.6%. Avoiding preterm birth continues to be the most important measure to reduce incidence, complemented by strategies such as delayed clamping of the umbilical cord, use of caffeine and avoiding orotracheal intubation.

Keywords: Intraventricular; Newborn; Very low birth weight.