Neurodevelopmental outcomes of neonatal posthemorrhagic hydrocephalus and psychological effects on the parents

Childs Nerv Syst. 2023 Aug;39(8):2115-2122. doi: 10.1007/s00381-023-05935-y. Epub 2023 Apr 20.

Abstract

Background: Neonatal posthemorrhagic hydrocephalus remains a common complication in preterm infants, with high rates of mortality and morbidity, placing parents at high risk of anxiety and depression. We sought to investigate the neurodevelopmental outcomes of infants with posthemorrhagic hydrocephalus who underwent surgery and the psychological effect on their parents.

Methods: We retrospectively analysed all infants with posthemorrhagic hydrocephalus born between 2014 and 2020 in the Children's Hospital of Chongqing Medical University, China. The neurodevelopmental outcomes of 28 patients were evaluated by the Pediatric Stroke Outcome Measure score, and the psychological states of the parents of survivors were assessed by the Hospital Anxiety and Depression Scale.

Results: The families of the 28 patients were followed up for a median duration of 3 years; 6 (21.4%) patients died within 6 months after discharge, 12 (42.9%) patients had moderate to severe dysfunction, and only 10 (35.7%) patients had good outcomes. Regarding the 22 parents of the survivors, 5 (22.7%) and 4 (18.2%) had borderline anxiety and depression symptoms, respectively. Two (9.1%) caregivers had exact anxiety and depression symptoms. Leukomalacia after intraventricular haemorrhage was associated with adverse neurological outcomes. The infants' histories of epileptic seizures during the neonatal period were associated with the anxiety of their parents.

Conclusion: The overall outcome of posthemorrhagic hydrocephalus patients is unsatisfactory, and children with leukomalacia after haemorrhage tend to have poor outcomes. A history of epileptic seizures during the course of the disease may exacerbate the anxiety of the caregivers.

Keywords: Anxiety; Depression; Intraventricular haemorrhage; Outcomes; Posthemorrhagic hydrocephalus.

MeSH terms

  • Cerebral Hemorrhage / complications
  • Child
  • Humans
  • Hydrocephalus* / complications
  • Hydrocephalus* / surgery
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Retrospective Studies
  • Seizures / complications