The incidence of periventricular/intraventricular haemorrhages among premature infants in a tertiary care hospital in Sri Lanka

Objectives: To describe the incidence and associated risk factors for periventricular/intraventricular haemorrhages (PVH/IVH) among premature infants in the neonatal intensive care unit (NICU) at Sri Jayewardenepura General Hospital (SJGH).

Method: A prospective descriptive study was conducted on all babies <37weeks with birth weights <2500g managed in NICU at SJGH over a period of 6 months. Data was collected using a pre-tested form. Previously defined ultrasound findings were used to diagnose and categorize the PVH/IVH. Birth weight, gestational age, hypocarbia, mechanical ventilation, vasopressor infusions and use of antenatal steroids were assessed as risk factors for PVH/IVH.

Results: A total of 126 babies was studied. The overall incidence of PVH/IVH was 12 (9.5%), 92% being grade 1. The incidence of PVH/IVH according to gestational age was 24.5% for <32 week old babies and 3.5% for 32-36 week old babies. Incidences according to birth weights were 43% (<1000g), 22% (1000-1500g) and 7% (1501-2000g). Of the babies with PVH/IVH 8% had been ventilated with CPAP mode whilst 92% had been given IPPV (p<0.0001); 83% had hypocarbia (p<0.0001) and 75% had been given vasopressors (p<0.0001). PVH/IVH was seen in 8% and 13% of those receiving and not receiving antenatal steroids respectively (p>0.05).

Conclusions: Incidence of PVH/IVH was inversely proportional to birth weight and gestational age. It was significantly higher (p<0.0001) in babies requiring IPPV, in those with hypocarbia and in those treated with vasopressors but was not significantly associated with administration of antenatal steroids (p>0.05).

Sri Lanka Journal of Child Health, 2012: 41(1): 24-28

(Key words: prematurity; low birth weight; intraventricular haemorrhage; periventricular haemorrhage; PVH/IVH)

DOI: http://dx.doi.org/10.4038/sljch.v41i1.4133