Objective To research the risk factors of ventricular hemorrhage in very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI),in order to provide the basis for clinical treatment. Methods Clinical data of 185 inpatients with VLBWI and ELBWI from division of Neonatology,the Affiliated Hospital of Guangdong Medical University from July 2016 to July 2018 were collected.And factors which may cause ventricular hemorrhage were determined by single factor analysis and multivariate Logistic regression analysis. Results Logistic regression analysis showed that hypoglycemia (OR=8.772,95%CI:2.880―26.720,P＜0.01),low hematocrit(OR=0.211,95%CI:0.072―0.618,P=0.005),sepsis (OR=6.427,95%CI:2.306-17.911,P＜0.01) and mechanical ventilation (OR=2.984,95%CI:1.013-8.785,P=0.047) were independent risk factors for ventricular hemorrhage. Conclusionss Very low birth weight infants and extremely low birth weight infant are at a higher risk for intraventricular hemorrhage.Active prevention of hypoglycemia,low hemoglobin congestion,infection and reasonable mechanical ventilation can help reduce the occurrence of intraventricular hemorrhage in very low birth weight infants and extremely low birth weight infants.
Key words
ventricular hemorrhage /
very low birth weight infant /
extremely low birth infant /
risk factor
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References
[1] Merhar SL,Tabangin ME,Meinzenderr J,et al.Grade and laterality of intraventricular hemorrhage to predict 18-22 month neurodevelopmental outcomes in extremely low birth weight infants[J].Acta Paediatr,2012,101(4):414-418.
[2] 中国新生儿重症监护室协作性质量改进研究协作组.极低和超低出生体重儿重度脑室内出血发生情况及其影响因素多中心研究[J].中华儿科杂志,2019,57(4):258-264.
[3] Villamor-Martinez E,Fumagalli M,Mohammed RO,et al.Chorioamnionitis is a risk factor for intraventricular hemorrhage in preterm infants:A systematic review and Meta-analysis[J].Front Physiol,2018,9(11):1253-1270.
[4] Papile LA,Burstein J,Burstein R,et al.Incidence and evolution of subependymal and intraventricular hemorrhage[J].J Pediatr,1978,92(4):529-534.
[5] Briana DD,Malamitsi-Puchner A.Low-grade intraventricular hemorrhage of preterm infants:neurodevelopmental and motor outcome[J].J Matern-Fetal Neo Med,2019,5:1-11.
[6] Linsell L,Malouf R,Morris J,et al.Prognostic factors for cerebral palsy and motor impairment in children born very preterm or very low birthweight:a systematic review[J].Dev Med Child Neurol,2016,58(6):554-569.
[7] 姜红,宋振凤,李向红,等.极低出生体重儿脑室周围-脑室内出血高危因素分析[J].中国实用儿科杂志,2012,27(1):39-41.
[8] Carney EF.Risk factors:Relationship between sodium intake and mortality[J].Nat Rev Nephrol,2016,12(12):715.
[9] Coskun Y,Isik S,Bayram T,et al.A clinical scoring system to predict the development of intraventricular hemorrhage (IVH) in premature infants[J].Childs Nerv Syst,2018,34:129-136.
[10] 刘维民,鲍秀兰,马磊,等.早期干预降低极低出生体重儿脑瘫发生率的临床研究[J].中国儿童保健杂志,2015,23(4):360-363.
[11] 黄水清,陈运彬,吴婕翎.极低出生体重儿脑室周围-脑室内出血的相关因素[J].中华围产医学杂志,2002,5(2):32-35.
[12] 吴玫瑰,黄志坚,李坚,等.早产儿低血糖与胎龄、体重、脑损伤关系的分析[J].广州医药,2014,45(1):50-52.
[13] Hume R,Burchell A.Glucose homeostasis in the newborn[J].Early Hum Dev,2005,81(1):95-101.
[14] Toledo JD,Rodilla S,Pérez-Iranzo A,et al.Umbilical cord milking reduces the risk of intraventricular hemorrhage in preterm infants born before 32 weeks of gestation[J].J Perinatol,2019,39:547-553.
[15] Vogtmann C,Koch R,Gmyrek D,et al.Risk-adjusted intraventricular hemorrhage rates in very premature infants:towards quality assurance between neonatal units[J].Dtsch Arztebl Int,2012,109:527-33.
[16] 宋金枝,文飞球,黄进洁.机械通气对极低出生体重儿脑室内出血影响的研究[J].中国实用儿科杂志,2008,23(5):362-364.
[17] Noori S,McCoy M,Anderson MP,et al.Changes in cardiac function and cerebral blood flow in relation to peri/intraventricular hemorrhage in extremely preterm infants[J].J Pediatr,2014,164:264-270.
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