A simple scoring system for prediction of IVH in very-low-birth-weight infants.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
26
01
2023
accepted:
03
07
2023
revised:
30
06
2023
medline:
24
11
2023
pubmed:
22
7
2023
entrez:
21
7
2023
Statut:
ppublish
Résumé
To develop a simple scoring system to predict either any or severe IVH in VLBW infants. In this retrospective cohort study, 923 VLBW infants were randomly divided into derivation (n = 431) and validation (n = 492) cohorts. After stepwise multivariable logistic regression analyses, a risk score was assigned to independent predictors. The overall rates of any and severe IVH were 22.9% and 9.9%. Gestational age, maternal race, location of birth and sex were independent predictors of any IVH (AUC 0.75 in derivation cohort and 0.69 for validation cohort). Birth weight, Apgar score at 1 minute, location of birth and sex were independent predictors of severe IVH (AUC 0.84 in derivation cohort and 0.77 for validation cohort). For any IVH, infants in the high-risk category (total score 4 or 5) had > 50% likelihood of any IVH with a negative predictive value of 82.6%. For severe IVH, the total risk score ranged from 0-8, and infants in high-risk category (total score 6-8) had 30% likelihood of severe IVH with a negative predictive value of 94.9%. We report an easy to calculate, validated scoring system with a high NPV to identify VLBW infants at highest risk of IVH. We report a simple validated scoring system with a high NPV for prediction of IVH in VLBW infants. The variables in the proposed model are available at birth and unlikely to be influenced by provider bias. This scoring system can identify infants at risk of any and severe IVH, while most previous models predict only severe IVH. This scoring system does not require access to web-based resources. This scoring system can help in employing prevention strategies only for infants at highest risk of IVH and thus eliminate the risks of interventions in a large majority of VLBW infants.
Sections du résumé
BACKGROUND
BACKGROUND
To develop a simple scoring system to predict either any or severe IVH in VLBW infants.
METHODS
METHODS
In this retrospective cohort study, 923 VLBW infants were randomly divided into derivation (n = 431) and validation (n = 492) cohorts. After stepwise multivariable logistic regression analyses, a risk score was assigned to independent predictors.
RESULTS
RESULTS
The overall rates of any and severe IVH were 22.9% and 9.9%. Gestational age, maternal race, location of birth and sex were independent predictors of any IVH (AUC 0.75 in derivation cohort and 0.69 for validation cohort). Birth weight, Apgar score at 1 minute, location of birth and sex were independent predictors of severe IVH (AUC 0.84 in derivation cohort and 0.77 for validation cohort). For any IVH, infants in the high-risk category (total score 4 or 5) had > 50% likelihood of any IVH with a negative predictive value of 82.6%. For severe IVH, the total risk score ranged from 0-8, and infants in high-risk category (total score 6-8) had 30% likelihood of severe IVH with a negative predictive value of 94.9%.
CONCLUSION
CONCLUSIONS
We report an easy to calculate, validated scoring system with a high NPV to identify VLBW infants at highest risk of IVH.
IMPACT
CONCLUSIONS
We report a simple validated scoring system with a high NPV for prediction of IVH in VLBW infants. The variables in the proposed model are available at birth and unlikely to be influenced by provider bias. This scoring system can identify infants at risk of any and severe IVH, while most previous models predict only severe IVH. This scoring system does not require access to web-based resources. This scoring system can help in employing prevention strategies only for infants at highest risk of IVH and thus eliminate the risks of interventions in a large majority of VLBW infants.
Identifiants
pubmed: 37479747
doi: 10.1038/s41390-023-02744-6
pii: 10.1038/s41390-023-02744-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2033-2039Informations de copyright
© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
Références
Stoll, B. J. et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 126, 443–456 (2010).
doi: 10.1542/peds.2009-2959
pubmed: 20732945
Patra, K., Wilson-Costello, D., Taylor, H. G., Mercuri-Minich, N. & Hack, M. Grades I–II intraventricular hemorrhage in extremely low birth weight infants: effects on neurodevelopment. J. Pediatr. 149, 169–173 (2006).
doi: 10.1016/j.jpeds.2006.04.002
pubmed: 16887428
Bolisetty, S. et al. Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants. Pediatrics 133, 55–62 (2014).
doi: 10.1542/peds.2013-0372
pubmed: 24379238
Mukerji, A., Shah, V. & Shah, P. S. Periventricular/Intraventricular Hemorrhage and Neurodevelopmental Outcomes: A Meta-analysis. Pediatrics 136, 1132–1143 (2015).
doi: 10.1542/peds.2015-0944
pubmed: 26598455
Ballabh, P. Pathogenesis and Prevention of Intraventricular hemorrhage. Clin. Perinatol. 41, 47–67 (2014).
doi: 10.1016/j.clp.2013.09.007
pubmed: 24524446
Shankaran, S. et al. Maternal race, demography, and health care disparities impact risk for intraventricular hemorrhage in preterm neonates. J. Pediatr. 164, 1005–1011 (2014).
doi: 10.1016/j.jpeds.2014.01.036
pubmed: 24589078
pmcid: 4095864
McGoldrick, E., Stewart, F., Parker, R. & Dalziel, S. R. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst. Rev. 12, CD004454 (2020).
pubmed: 33368142
Smit, E., Odd, D. & Whitelaw, A. Postnatal phenobarbital for the prevention of intraventricular haemorrhage in preterm infants. Cochrane Database Syst. Rev. 8, CD001691 (2013).
Fowlie, P. W., Davis, P. G. & McGuire, W. Prophylactic intravenous indomethacin for preventing mortality and morbidity in preterm infants. Cochrane Database Syst. Rev. 7, CD000174 (2010).
Carteaux, P. et al. Evaluation and development of potentially better practices for the prevention of brain hemorrhage and ischemic brain injury in very low birth weight infants. Pediatrics 111, e489–e496 (2003).
doi: 10.1542/peds.111.SE1.e489
pubmed: 12671169
Jasani, B., Torgalkar, R., Ye, X. Y., Syed, S. & Shah, P. S. Association of umbilical cord management strategies with outcomes of preterm infants: A systematic review and network meta-analysis. JAMA Pediatr. 175, e210102 (2021).
doi: 10.1001/jamapediatrics.2021.0102
pubmed: 33683307
pmcid: 7941254
Tarnow-Mordi, W. et al. Delayed versus immediate cord clamping in preterm infants. N. Engl. J. Med. 377, 2445–2455 (2017).
doi: 10.1056/NEJMoa1711281
pubmed: 29081267
Fogarty, M. et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. 218, 1–18 (2018).
doi: 10.1016/j.ajog.2017.10.231
pubmed: 29097178
Yao, S. L., Smit, E. & Odd, D. The effectiveness of interventions to prevent intraventricular haemorrhage in premature infants: A systematic review and network meta-analysis. J. Neonatal Perinat. Med. 16, 5–20 (2023).
doi: 10.3233/NPM-221048
Romantsik, O., Calevo, M. G. & Bruschettini, M. Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular haemorrhage in preterm infants. Cochrane Database Syst. Rev. 7, CD012362 (2020).
pubmed: 32639053
Kumar, P. et al. Elevated supine midline head position for prevention of intraventricular hemorrhage in VLBW and ELBW infants: a retrospective multicenter study. J. Perinatol. 41, 278–285 (2021).
doi: 10.1038/s41372-020-00809-6
pubmed: 32901115
Papile, L. A., Burstein, J., Burstein, R. & Koffler, H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J. Pediatr. 92, 529–534 (1978).
doi: 10.1016/S0022-3476(78)80282-0
pubmed: 305471
Gursoy, T., Hayran, M., Derin, H. & Ovali, F. A clinical scoring system to predict the development of bronchopulmonary dysplasia. Am. J. Perinatol. 32, 659–666 (2015).
pubmed: 25285400
Heuchan, A. M., Evans, N., Henderson, D. J. & Simpson, J. M. Perinatal risk factors for major intraventricular haemorrhage in the Australian and New Zealand Neonatal. Netw., 1995-97. Arch. Dis. Child. Fetal Neonatal Ed. 86, F86–F90 (2002).
doi: 10.1136/fn.86.2.F86
Singh, R. et al. A predictive model for SIVH risk in preterm infants and targeted indomethacin therapy for prevention. Sci. Rep. 3, 2539 (2013).
doi: 10.1038/srep02539
pubmed: 23995978
pmcid: 3759046
Luque, M. J. et al. A risk prediction model for severe intraventricular hemorrhage in very low birth weight infants and the effect of prophylactic indomethacin. J. Perinatol. 34, 43–48 (2014).
doi: 10.1038/jp.2013.127
pubmed: 24113396
Coskun, Y. et al. A clinical scoring system to predict the development of intraventricular hemorrhage (IVH) in premature infants. Childs Nerv. Syst. 34, 129–136 (2018).
doi: 10.1007/s00381-017-3610-z
pubmed: 29026981
Lee, J., Hong, M., Yum, S. K. & Lee, J. H. Perinatal prediction model for severe intraventricular hemorrhage and the effect of early postnatal acidosis. Childs Nerv. Syst. 34, 2215–2222 (2018).
doi: 10.1007/s00381-018-3868-9
pubmed: 29916044
Chawla, S. et al. Model for severe intracranial hemorrhage and role of early indomethacin in extreme preterm infants. Pediatr. Res. 92, 1648–1656 (2022).
doi: 10.1038/s41390-022-02012-z
pubmed: 35301420
pmcid: 9481746
Poryo, M. et al. Ante-, peri- and postnatal factors associated with intraventricular hemorrhage in very premature infants. Early Hum. Dev. 116, 1–8 (2018).
doi: 10.1016/j.earlhumdev.2017.08.010
pubmed: 29091782
Ancel, P. Y. et al. Are maternal hypertension and small-for-gestational age risk factors for severe intraventricular hemorrhage and cystic periventricular leukomalacia? Results of the EPIPAGE cohort study. Am. J. Obstet. Gynecol. 193, 178–184 (2005).
doi: 10.1016/j.ajog.2004.11.057
pubmed: 16021076
Bossung, V. et al. Neonatal Outcome after Preeclampsia and HELLP Syndrome: A Population-Based Cohort Study in Germany. Front Pediatr. 12, 579293 (2020).
doi: 10.3389/fped.2020.579293
Sloane, A. J. et al. Hypertensive disorders during pregnancy are associated with reduced severe intraventricular hemorrhage in very-low-birth-weight infants. J. Perinatol. 39, 1125–1130 (2019).
doi: 10.1038/s41372-019-0413-y
pubmed: 31263202