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Perinatal prediction model for severe intraventricular hemorrhage and the effect of early postnatal acidosis

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Abstract

Purpose

Severe acidosis is one of the strongest predictors of neurologic outcomes in full-term infants with suspected hypoxic-ischemic encephalopathy. However, the relative importance of acidosis as a predictor of outcomes in preterm infants is much less clear. The goals of the present study were to examine the association between postnatal acidosis and severe intraventricular hemorrhage (IVH) and to establish a new score model including acid-base status after birth for predicting the risk of this morbidity.

Methods

The study sample was very low birth weight (VLBW) infants in the Korean Neonatal Network (KNN) cohort registry, collected prospectively from January 2013 to December 2014. Infants with blood pH and base deficit (BD) values collected within the first hour after birth, and documentation of severe IVH, were included. Multivariate stepwise logistic regression analysis was used to determine the contribution of postnatal acidosis to predicting severe IVH in VLBW infants. In addition, a prediction model was developed.

Results

Data from 2518 VLBW infants were analyzed. Infants with postnatal acidosis had a higher incidence of severe IVH. The clinical model plus blood BD values improved predictive performance, compared with models using only perinatal data or blood pH.

Conclusions

A prediction model for severe IVH was developed using the KNN registry of VLBW infants. Immediate postnatal acidosis, defined based on blood BD, was associated with a higher-risk-adjusted incidence of severe IVH.

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Acknowledgements

This study was supported by the research program funded by the Korea Centers for Disease Control and Prevention (2016-ER6307-01) and statistical consultation was provided by a grant from the Korea Health Technology R&D Project from the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1062).

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Authors and Affiliations

  1. Department of Pediatrics, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Juyoung Lee

  2. Department of Pediatrics, St. Vincent’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Mee Hong & Jung Hyun Lee

  3. Department of Pediatrics, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Sook Kyung Yum

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  1. Juyoung Lee
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  2. Mee Hong
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Correspondence to Jung Hyun Lee.

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The authors have no conflict of interest or any financial relationships relevant to this article to disclose.

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Lee, J., Hong, M., Yum, S.K. et al. Perinatal prediction model for severe intraventricular hemorrhage and the effect of early postnatal acidosis. Childs Nerv Syst 34, 2215–2222 (2018). https://doi.org/10.1007/s00381-018-3868-9

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  • DOI: https://doi.org/10.1007/s00381-018-3868-9

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