Objective: To study the risk factors for intracranial hemorrhage in very low birth weight infants.
Methods: Data from 169 very low birth weight (VLBW) infants (birth weight 1000-1500 g; gestational age 23-36 weeks) were studied retrospectively. Twenty-nine perinatal and postnatal factors were analyzed by Crosstabs Test with SPSS 12.0. A logistic regression analysis was used to identify the risk factors associated with the development of intracranial hemorrhage.
Results: Multivariate logistic analysis revealed that rupture of membranes (OR=0.146, 95%CI=0.22-0.964, P < 0.05), 1-minute Apgar score < or = 7 (OR=0.112, 95%CI=0.21-0.591, P < 0.01), pulmonary surfactant therapy (OR=0.110, 95%CI=0.24-0.504, P < 0.01), mechanical ventilation therapy (OR =0.076, 95%CI=0.009-0.668, P < 0.05), mechanical ventilation duration > 72 hrs(OR=0.053, 95%CI=0.007-0.410, P < 0.01), prothrombin time > 20 seconds (OR=4.186, 95%CI=1.606-10.923, P < 0.01), pH value on day 1 of life < 7.25 (OR=0.421, 95%CI=0.179-0.995, P < 0.05) and hyponatremia on day 1 (OR= 0.27, 95%CI=0.077-0.940, P < 0.05) or 2 (OR=2.480, 95%CI=1.053-5.838, P < 0.05) of life were risk factors for intracranial hemorrhage.
Conclusions: 1-minute Apgar score < or =7 and mechanical ventilation treatment were leading risk factors for intracranial hemorrhage, followed by abnormal coagulation and electrolytes related to perinatal asphyxia in VLBW infants. These findings can be used to improve the surveillance and prophylaxis measures in VLBW infants at high risk.