The interplay between birth weight and intraventricular hemorrhage in very preterm neonates - a retrospective cohort study
Abstract
BACKGROUND
Intraventricular hemorrhage (IVH) most commonly occurs in infants born very preterm (<32 weeks' gestation). There are mixed findings on whether infants small for gestational age (SGA) or with suspected fetal growth restriction (FGR) are at higher risk for IVH. Understanding the relationship between SGA or FGR and IVH is critical to inform clinical care.
OBJECTIVE
The primary aim was to determine the rates of IVH in very preterm newborns, with SGA or suspected FGR, and to stratify for severity of both FGR and IVH. The secondary aim was to identify risk factors for IVH in a large contemporary cohort.
STUDY DESIGN
A population-based retrospective cohort study using data from the Australian and New Zealand Neonatal Network (ANZNN). Participants were babies born before 32 weeks' gestation (22 to 31 weeks + 6 days gestation) between 2014-2019 inclusive. The primary outcomes were IVH and severity of IVH. Small babies were classified as being SGA (SGA; birth weight <10th percentile), suspected FGR (birth weight <10th and ≥3rd birth weight percentile and abnormal antenatal ultrasound), or severe FGR (birth weight <3rd percentile). Multivariate regression was then performed, adjusting for potential maternal and fetal confounders to determine the association between FGR and IVH.
RESULTS
20,551 very preterm newborns were included in the study with a median gestational age (25th, 75th) of 29 (27,30) weeks gestation and birth weight of 1201(383.9) grams. The incidence of any…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 4,115 participants or records.
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