Outcomes Following Post-Hemorrhagic Ventricular Dilatation among Infants of Extremely Low Gestational Age

Seetha Shankaran; Monika Bajaj; Girija Natarajan; Shampa Saha; Athina Pappas; Alexis S. Davis; Susan R. Hintz; Ira Adams-Chapman; Abhik Das; Edward F. Bell; Barbara J. Stoll; Michele C. Walsh; Abbot R. Laptook; Waldemar A. Carlo; Krisa P. Van Meurs; Pablo J. Sánchez; M. Bethany Ball; Ellen C. Hale; Ruth Seabrook; Rosemary D. Higgins; National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1016/j.jpeds.2020.07.080

Back

Outcomes Following Post-Hemorrhagic Ventricular Dilatation among Infants of Extremely Low Gestational Age

Journal article

Peer reviewed

Outcomes Following Post-Hemorrhagic Ventricular Dilatation among Infants of Extremely Low Gestational Age

Seetha Shankaran, Monika Bajaj, Girija Natarajan, Shampa Saha, Athina Pappas, Alexis S. Davis, Susan R. Hintz, Ira Adams-Chapman, Abhik Das, Edward F. Bell, …

The Journal of pediatrics, Vol.226, pp.36-44.e3

11/2020

DOI: 10.1016/j.jpeds.2020.07.080

PMCID: PMC7855243

PMID: 32739261

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/7855243View

Open Access

Abstract

To assess outcomes following post-hemorrhagic ventricular dilatation (PHVD) among infants born at ≤26 weeks of gestation. Observational study of infants born April 1, 2011, to December 31, 2015, in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and categorized into 3 groups: PHVD, intracranial hemorrhage without ventricular dilatation, or normal head ultrasound. PHVD was treated per center practice. Neurodevelopmental impairment at 18-26 months was defined by cerebral palsy, Bayley Scales of Infant and Toddler Development, 3rd edition, cognitive or motor score <70, blindness, or deafness. Multivariable logistic regression examined the association of death or impairment, adjusting for neonatal course, center, maternal education, and parenchymal hemorrhage. Of 4216 infants, 815 had PHVD, 769 had hemorrhage without ventricular dilatation, and 2632 had normal head ultrasounds. Progressive dilatation occurred among 119 of 815 infants; the initial intervention in 66 infants was reservoir placement and 53 had ventriculoperitoneal shunt placement. Death or impairment occurred among 68%, 39%, and 28% of infants with PHVD, hemorrhage without dilatation, and normal head ultrasound, respectively; aOR (95% CI) were 4.6 (3.8-5.7) PHVD vs normal head ultrasound scan and 2.98 (2.3-3.8) for PHVD vs hemorrhage without dilatation. Death or impairment was more frequent with intervention for progressive dilatation vs no intervention (80% vs 65%; aOR 2.2 [1.38-3.8]). Death or impairment increased with parenchymal hemorrhage, intervention for PHVD, male sex, and surgery for retinopathy; odds decreased with each additional gestational week. PHVD was associated with high rates of death or impairment among infants with gestational ages ≤26 weeks; risk was further increased among those with progressive ventricular dilation requiring intervention.

extremely low gestational age infants

outcome

post-hemorrhagic ventricular dilatation

Details

Title: Subtitle: Outcomes Following Post-Hemorrhagic Ventricular Dilatation among Infants of Extremely Low Gestational Age
Creators: Seetha Shankaran - Wayne State University
Monika Bajaj - Wayne State University
Girija Natarajan - Wayne State University
Shampa Saha - RTI International
Athina Pappas - Wayne State University
Alexis S. Davis - Lucile Packard Children's Hospital
Susan R. Hintz - Lucile Packard Children's Hospital
Ira Adams-Chapman - Children's Healthcare of Atlanta
Abhik Das - RTI International
Edward F. Bell - University of Iowa
Barbara J. Stoll - The University of Texas Health Science Center
Michele C. Walsh - Case Western Reserve University
Abbot R. Laptook - Women & Infants Hospital of Rhode Island
Waldemar A. Carlo - University of Alabama at Birmingham
Krisa P. Van Meurs - Lucile Packard Children's Hospital
Pablo J. Sánchez - Nationwide Children's Hospital
M. Bethany Ball - Lucile Packard Children's Hospital
Ellen C. Hale - Children's Healthcare of Atlanta
Ruth Seabrook - Nationwide Children's Hospital
Rosemary D. Higgins - George Mason University
National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.226, pp.36-44.e3
DOI: 10.1016/j.jpeds.2020.07.080
PMID: 32739261
PMCID: PMC7855243
NLM abbreviation: J Pediatr
ISSN: 0022-3476
eISSN: 1097-6833
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100009633, name: Eunice Kennedy Shriver National Institute of Child Health and Human Development; name: NICHD; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100009633, name: Eunice Kennedy Shriver National Institute of Child Health and Human Development; name: NICHD, award: U10 HD21373, UG1 HD21364, UG1 HD21385; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000071, name: NICHD, award: U10 HD21373, UG1 HD21364, UG1 HD21385, UG1 HD27851, UG1 HD27853, UG1 HD27856, UG1 HD27880, UG1 HD27904, UG1 HD34216, UG1 HD36790, UG1 HD40492, UG1 HD40689, UG1 HD53089, UG1 HD53109, UG1 HD68244, UG1 HD68270, UG1 HD68278, UG1 HD68263, UG1 HD68284, UG1 HD87226, UG1 HD87229; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences; DOI: 10.13039/100006108, name: NCATS, award: UL1 TR6, UL1 TR41, UL1 TR42, UL1 TR77, UL1 TR93, UL1 TR105, UL1 TR442, UL1 TR454, UL1 TR1117
Language: English
Date published: 11/2020
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984354153302771

Metrics

10 Record Views

30 Times Cited - Web of Science