Risk factor analyses for intraventricular hemorrhage in preterm infants: A retrospective cohort study.

ABSTRACT

BACKGROUND: Very-low-birthweight (VLBW) infants can experience severe intraventricular hemorrhage (IVH) that can lead to life-long disability by impairing neurodevelopment. The aim of this study was to identify the risk and protective factors for severe IVH in VLBW infants. METHODS: A retrospective, cross-sectional review of VLBW infants born at 22-28 weeks' gestation between January 2003 and December 2012 and listed in the Database of Neonatal Research Network in Japan was performed using a statistical model incorporating an odds ratio (OR) and medical center variation as a center variance ratio (CVR). A two-dimensional analysis using a combination of OR and the CVR described evolving measures of a clinical trial (for OR > 1) and standardization (for CVR > 1) concerning a factor of interest. RESULTS: The noteworthy significant protective factors were antenatal steroids (ANS) with and without premature rupture of membrane (OR 0.43, CVR 1.08, and OR 0.68, CVR 1.14, respectively) and the number of neonatal beds (OR 0.94, CVR 0.99) and staff nurses per neonatal bed (OR 0.89, CVR 0.99). CONCLUSIONS: Active promotion of ANS administration and consolidation of perinatal medical centers can mitigate the development of severe IVH in VLBW infants.