Intraventricular Hemorrhage in Very Preterm Children: Mortality and Neurodevelopment at Age 5.
Humans
Male
Female
Infant, Newborn
Infant
Child, Preschool
Infant, Extremely Premature
Hemorrhage
Neurodevelopmental Disorders
/ epidemiology
Cerebral Hemorrhage
/ complications
Gestational Age
Case-Control Studies
France
/ epidemiology
Cerebral Palsy
Prospective Studies
Hospital Mortality
Premature Birth
/ mortality
Journal
Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
accepted:
22
12
2022
pmc-release:
01
04
2024
medline:
4
4
2023
pubmed:
16
3
2023
entrez:
15
3
2023
Statut:
ppublish
Résumé
The objectives were to describe mortality and causes of death in children with intraventricular hemorrhage (IVH) and to study neurodevelopmental outcomes. The study was a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2. Children were recruited in 2011. A standardized assessment was conducted at age 5. Children born before 32 weeks' gestation and admitted to a NICU were eligible. Exposure was IVH defined by the Papile classification. Main outcomes were mortality, causes of death, and neurodevelopmental outcomes at age 5. Among the 3468 children included, 578 (16.7%) had grade 1 IVH, 424 (12.2%) grade 2 IVH, and 114 (3.3%) grade 3 IVH; 144 (4.1%) had intraparenchymal hemorrhage (IPH). Mortality was 29.7% (36 of 114) for children with grade 3 IVH and 74.4% (109 of 144) for those with IPH; 67.6% (21 of 31) and 88.7% (86 of 97) of deaths, respectively, were because of withholding and withdrawing of life-sustaining treatment. As compared with no IVH, low-grade IVH was not associated with measured neurodevelopmental disabilities at age 5. High-grade IVH was associated with moderate and severe neurodevelopmental disabilities, reduced full-scale IQ, and cerebral palsy. Rates of neurodevelopmental disabilities at age 5 did not differ between children without IVH and those with low-grade IVH. For high-grade IVH, mortality rate was high, mostly because of withholding and withdrawal of life-sustaining treatment, and we found a strong association with overall neurodevelopmental disabilities in survivors.
Identifiants
pubmed: 36919442
pii: 190840
doi: 10.1542/peds.2022-059138
pmc: PMC10071431
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 by the American Academy of Pediatrics.
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