Neonatal Intraventricular Hemorrhage and Hospitalization in Childhood

Pediatr Neurol. 2020 Feb:103:35-42. doi: 10.1016/j.pediatrneurol.2019.09.007. Epub 2019 Oct 19.

Abstract

Background: Intraventricular hemorrhage is a serious neonatal complication associated with neurodevelopmental disorders, but the relationship with other childhood morbidities is unclear. We sought to assess the association of neonatal intraventricular hemorrhage with the risk of morbidity up to 12 years of age.

Methods: We analyzed a cohort of 794,384 infants born between 2006 and 2016 in Quebec, Canada, with 4,269,579 person-years of follow-up. The exposure was grade I to IV intraventricular hemorrhage in the neonatal period. The main outcome measure was childhood hospitalization by cause of admission. In adjusted Cox regression models, we estimated hazard ratios and 95% confidence intervals for the association of intraventricular hemorrhage with future childhood hospitalization.

Results: Infants with intraventricular hemorrhage had a higher incidence of childhood hospitalization than infants without hemorrhage (23.8 vs. 5.7 per 100 person-years). Compared with those with no hemorrhage, infants with intraventricular hemorrhage had 1.56 times the risk of hospitalization (95% confidence interval, 1.43-1.70). The risk was 2.81 times higher for grade III/IV hemorrhage (95% confidence interval, 2.23-3.53). Intraventricular hemorrhage at term was associated with 3.19 times the risk of hospitalization (95% confidence interval, 2.55-4.00), whereas preterm intraventricular hemorrhage was associated with 2.06 times the risk before 28 weeks (95% confidence interval, 1.75-2.42) and 1.87 times the risk between 28 and 36 weeks (95% confidence interval, 1.68-2.08), compared with no hemorrhage at term. Primary reasons for hospitalizations included central nervous system, ophthalmologic, musculoskeletal, and cardiovascular disorders.

Conclusions: Intraventricular hemorrhage, especially of higher grades and in term neonates, is a predictor of future risk of hospitalization in childhood.

Keywords: Cerebral hemorrhage; Hospitalization; Infants; Longitudinal studies; Morbidity; Premature; Term birth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Central Nervous System Diseases / epidemiology*
  • Central Nervous System Diseases / therapy
  • Cerebral Intraventricular Hemorrhage / epidemiology*
  • Child
  • Child, Preschool
  • Eye Diseases / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Longitudinal Studies
  • Male
  • Musculoskeletal Diseases / epidemiology*
  • Quebec / epidemiology
  • Registries / statistics & numerical data*
  • Retrospective Studies
  • Severity of Illness Index
  • Term Birth

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