Skip to main content
SpringerLink
Log in

Impact of low-grade intraventricular hemorrhage on long-term neurodevelopmental outcome in preterm infants

Child's Nervous System volume 28, pages 2085–2092 (2012)Cite this article

Abstract

Purpose

Despite a decreasing incidence, intraventricular hemorrhage (IVH) remains a point of major concern in neonatology due to its association to adverse neurodevelopmental outcome (NDO). Aim of this study was to compare outcome of preterm infants with different grades of IVH born below 32 weeks of gestational age (GA) with outcome of controls without IVH and to especially evaluate the influence of low grade IVH on NDO.

Methods

Four hundred seventy-one preterm infants with a GA below 32 weeks were admitted to our neonatal intensive care unit between 1994 and 2005 and included into analysis.

Results

IVH patients showed significantly lower mean psychomotor and mental developmental indices and a significantly higher percentage of cerebral palsy and visual impairment. Results of IVH patients born below 28 weeks of GA were significantly worse than results of IVH patients born at or above 28 weeks of GA. In all parameters, an increase of abnormal results with increasing grade of IVH could be observed; even patients with low-grade IVH (grades I and II) showed higher percentages of impairment compared to controls without any IVH.

Conclusion

Even low-grade IVH has an significant impact on neurodevelopmental outcome of preterm patients and gestational age influences the impact of intraventricular hemorrhage on neurodevelopmental outcome.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Bayley N (1993) Bayley Scales of Infant Development II. Psychological Corp, San Antonio, TX

    Google Scholar 

  2. Beery KE, Buktenica NA, Beery NA (2004) Manual 5th edition for assessment of visual-motor integration; MHS. Ontario, Canada

    Google Scholar 

  3. Brouwer A, Groenendaal F, van Haastert IL, Rademaker K, Hanlo P, de Vries L (2008) Neurodevelopmental outcome of preterm infants with severe intraventricular hemorrhage and therapy for post-hemorrhagic ventricular dilatation. J Pediatr 152(5):648–654

    Article  PubMed  Google Scholar 

  4. De Vries LS, Eken P, Dubowith LMS (1992) The spectrum of leucomalacia using cranial ultrasound. Behav Brain Res 49:1–6

    Article  PubMed  Google Scholar 

  5. De Vries LS, Rademaker KJ, Groenendaal F, Eken P, van Haastert IC, Vandertop WP, Gooskens R, Meiners LC (1998) Correlation between neonatal cranial ultrasound, MRI in infancy and neurodevelopmental outcome in infants with a large intraventricular haemorrhage with or without unilateral parenchymal involvement. Neuropediatrics 29(4):180–188

    Article  PubMed  Google Scholar 

  6. Harvey EM, Dobson V, Luna B, Scher MS (1997) Grating acuity and visual-field development in children with intraventricular hemorrhage. Dev Med Child Neurol 39(5):305–312

    Article  PubMed  CAS  Google Scholar 

  7. Hintz SR, Kendrick DE, Vohr BR, Poole WK, Higgins RD (2005) Changes in neurodevelopmental outcomes at 18 to 22 months’ corrected age among infants of less than 25 weeks’ gestational age born in 1993–1999. Pediatr 115:1645–1651

    Article  Google Scholar 

  8. Jakobi P, Weissman A, Zimmer EZ, Blazer S (1992) Survival and long-term morbidity in preterm infants with and without a clinical diagnosis of periventricular, intraventricular hemorrhage. Eur J Obstet Gynecol Reprod Biol 46(2–3):73–77

    Article  PubMed  CAS  Google Scholar 

  9. Konstantopoulos N, Henneberger S, Genzel-Boroviczeny O (2007) Entwicklungsprognose sehr kleiner Frühgeborener. Paediat Prax 70:373–383

    Google Scholar 

  10. Linder N, Haskin O, Levit O, Klinger G, Prince T, Naor N, Turner P, Karmazyn B, Sirota L (2003) Risk factors for intraventricular hemorrhage in very low birth weight premature infants: a retrospective case–control study. J Pediatr 111:e590–e595

    Article  Google Scholar 

  11. Maitre NL, Marshall DD, Price WA, Slaughter JC, O’Shea TM, Maxfield C, Goldstein RF (2009) Neurodevelopmental outcome of infants with unilateral or bilateral periventricular hemorrhagic infarction. Pediatr 124:e1153–e1160

    Article  Google Scholar 

  12. Mancini MC, Barbosa NE, Banwart D, Silveira S, Guerpelli JL, Leone CR (1999) Intraventricular hemorrhage in very low birth weight infants: associated risk factors and outcome in the neonatal period. Rev Hosp Clin Fac Med Sao Paulo 54(5):151–154

    Article  PubMed  CAS  Google Scholar 

  13. Melchers P (1991) Manual for Kaufmann assessment battery for children. Swets & Zeitlinger, Frankfurt/Main

    Google Scholar 

  14. Obladen M, Metze B, Henrich W, Atkas A, Czernik C, Schulz-Baldes A (2008) Interdisciplinary surveillance of intraventricular haemorrhage associated conditions in infants <1000g. Acta Paediatr 97(6):731–737

    Article  PubMed  Google Scholar 

  15. Patra K, Wilson-Costello D, Taylor HG, Mercuri-Minich N, Hack M (2006) Grades I–II intraventricular hemorrhage in extremely low birth weight infants: effects on neurodevelopment. J Pediatr 149(2):169–173

    Article  PubMed  Google Scholar 

  16. Papile LN, Burnstein J, Burnstein R, Koffler H (1978) Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birthweight less than 1500g. J Pediatr 92:529–534

    Article  PubMed  CAS  Google Scholar 

  17. Roze E, Van Braeckel KNJA, van der Veere CN, Maathuis CGB, Martijn A, Bos AF (2009) Functional outcome at school age of preterm infants with periventricular hemorrhagic infarction. Pediatr 123(6):1493–1500

    Article  Google Scholar 

  18. Sherlock RL, Anderson PJ, Doyle LW (2005) Neurodevelopmental sequelae of intraventricular haemorrhage at 8 years of age in a regional cohort of ELBW/very preterm infants. Early Hum Dev 81(11):909–916

    Article  PubMed  CAS  Google Scholar 

  19. Stewart AL, Thorburn RJ, Hope PL, Goldsmith M, Lipscomb AP, Reynolds EO (1983) Ultrasound appearance of the brain in very preterm infants and neurodevelopmental outcome at 18 months of age. Arch Dis Child 58:598–604

    Article  PubMed  CAS  Google Scholar 

  20. Vasileiadis GT, Gelman N, Han VK, Williams LA, Mann R, Bureau Y, Thompson RT (2004) Uncomplicated intraventricular hemorrhage is followed by reduced cortical volume at near term age. Pediatr 114(3):e367–e372

    Article  Google Scholar 

  21. Vohr B, Allan WC, Scott DT, Katz KH, Schneider KC, Makuch RW, Ment LR (1999) Early-onset intraventricular hemorrhage in preterm neonates: incidence of neurodevelopmental handicap. Semin Perinatol 23(3):212–217

    Article  PubMed  CAS  Google Scholar 

  22. Vohr BR, Allan WC, Westerveld M, Schneider KC, Katz KH, Makuch RW, Ment LR (2003) School- age outcomes of very low birth weight infants in the indomethacin intraventricular hemorrhage prevention trial. J Pediatr 111:e 340–e 346

    Google Scholar 

  23. Vollmer B, Roth S, Riley K, Sellwood MW, Baudin J, Neville BG, Wyatt JS (2006) Neurodevelopmental outcome of preterm infants with ventricular dilatation with and without associated haemorrhage. Dev Med Child Neurol 48(5):348–352

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neonatology; Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    K. Klebermass-Schrehof, C. Czaba, M. Olischar, R. Fuiko, Z. Rona, A. Pollak & M. Weninger

  2. Department of Epidemiology, Medical University of Vienna, Vienna, Austria

    T. Waldhoer

Authors
  1. K. Klebermass-Schrehof
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Czaba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Olischar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Fuiko
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Waldhoer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Z. Rona
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Pollak
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Weninger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Klebermass-Schrehof.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Klebermass-Schrehof, K., Czaba, C., Olischar, M. et al. Impact of low-grade intraventricular hemorrhage on long-term neurodevelopmental outcome in preterm infants. Childs Nerv Syst 28, 2085–2092 (2012). https://doi.org/10.1007/s00381-012-1897-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-012-1897-3

Keywords

search

Navigation