ABSTRACT
Intraventricular hemorrhage (IVH) is a multifactorial disorder, the most important risk factors of which are prematurity and low birth weight. Disturbances in cerebral blood flow, inherent fragility of the germinal matrix vasculature, and platelet/coagulation disturbances are the 3 major pathogenic mechanisms. In this context, we investigated the role of platelet indices and several maternal and neonatal characteristics in the development of IVH through a retrospective cohort analysis of 130 extremely premature neonates, 24% of whom presented with severe IVH. There was a significant difference in platelet counts between the IVH and the control group on the first day of life (P=0.046). Presence of IVH was linked with lower birth weight (P=0.006) and lower gestational age (P=0.001). Platelet count on the first day of life was positively correlated with survival (P=0.001) and, along with platelet mass, was indicative of the worst IVH grade recorded for each neonate (P=0.002 and 0.007, respectively). Prolonged prothrombin time was also correlated with IVH (P<0.001), but factor analysis supported no prominent role. Maternal medications seem to play a minor role as well. In conclusion, IVH in extremely premature infants cannot be solely explained by platelet parameters, and further studies are required to determine the relationships between IVH, platelet indices, and outcomes.
Subject(s)
Cerebral Hemorrhage/etiology , Infant, Extremely Premature/blood , Birth Weight , Cerebral Hemorrhage/blood , Cerebrovascular Circulation , Cohort Studies , Ductus Arteriosus, Patent/complications , Gestational Age , Heart Ventricles , Humans , Infant, Newborn , Mean Platelet Volume , Platelet Count , Retrospective StudiesABSTRACT
Intraventricular hemorrhage (IVH) is a multifactorial disorder, the most important risk factors of which are prematurity and low birth weight. Disturbances in cerebral blood flow, inherent fragility of the germinal matrix vasculature, and platelet/coagulation disturbances are the 3 major pathogenic mechanisms. In this context, we investigated the role of platelet indices and several maternal and neonatal characteristics in the development of IVH through a retrospective cohort analysis of 130 extremely premature neonates, 24% of whom presented with severe IVH. There was a significant difference in platelet counts between the IVH and the control group on the first day of life (P=0.046). Presence of IVH was linked with lower birth weight (P=0.006) and lower gestational age (P=0.001). Platelet count on the first day of life was positively correlated with survival (P=0.001) and, along with platelet mass, was indicative of the worst IVH grade recorded for each neonate (P=0.002 and 0.007, respectively). Prolonged prothrombin time was also correlated with IVH (P<0.001), but factor analysis supported no prominent role. Maternal medications seem to play a minor role as well. In conclusion, IVH in extremely premature infants cannot be solely explained by platelet parameters, and further studies are required to determine the relationships between IVH, platelet indices, and outcomes.
ABSTRACT
The aim of this study was to determine the clinical outcome of late preterm infants (LPI) week by week. Our patients were divided into three groups according to gestational age (GA); group A: 34 - 34+6/7 weeks, group B: 35 - 35+6/7 weeks and group C: 36 - 36+6/7 weeks. Out of 10650 deliveries, 1280 (12%) were late preterm, 1004 (78.5%) of which were carried out by caesarean section. A total of 1527 infants were studied with 565 (37%) requiring admission to NICU while 5 deaths were recorded (neonatal mortality rate was estimated at 3.2 ). Our study demonstrates that the rate of respiratory disorders, sepsis, feeding disorders and abnormal neurological examination in LPIs was inversely proportional to their GA. Furthermore, infants of 34+0/7 - 34+6/7 weeks of GA required a longer hospitalization in the NICU than their more mature peers.
