Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295 |
Resumo: | Introduction: Severe peri-intraventricular haemorrhage has been associated with higher mortality and neurodevelopmental impairment. The impact of peri-intraventricular haemorrhage alone (without white matter injury) remains controversial. The aim of this study was to evaluate the influence of severe peri-intraventricular haemorrhage, associated or not with cystic peri-ventricular leukomalacia, on mortality and neurodevelopment at 24 months.Material and Methods: Retrospective cohort study, that included newborns with severe peri-intraventricular haemorrhage admitted to a maternity hospital with differentiated perinatal support between 2006 and 2015, and two controls with the same gestational age, without peri-intraventricular haemorrhage, who were admitted immediately after the case. Neurodevelopmental assessment, at 24 months, was performed in 99 children, using the Schedule of Growing Skills II scale in 52 and the Ruth Griffiths mental development scale in 47 children. Severe neurodevelopmental deficit was diagnosed in the following conditions: cerebral palsy, delayed psychomotor development, deafness requiring hearing aids and blindness.Results: The study included 41 cases and 82 controls. Out of these, 23 died, 16 (39.0%) in the group of severe peri-intraventricular haemorrhage and seven (8.5%) in the control group (OR 7.6, 95% CI 2.6 - 20.4, p < 0.001). Severe neurodevelopmental deficit was diagnosed in seven (30.4%) in the severe peri-intraventricular haemorrhage group and one (1.3%) in the control group (OR 32; 95% CI 3.7 - 281, p < 0.001). Individualized analysis showed that mortality was higher in peri-intraventricular haemorrhage grade III with associated cystic peri-ventricular leukomalacia (OR 4.4 95% CI 1.3 - 14.2, p = 0.015) and in peri-intraventricular haemorrhage IV (OR 12; 95% CI 3.5 - 41.2, p < 0.001), when compared to controls. Differences were also noticed regarding severe neurodevelopmental deficit when compared with controls (1.3%) in grade III peri-intraventricular haemorrhage with associated cystic peri-ventricular leukomalacia, (75.0%, p < 0.001) and grade IV peri-intraventricular haemorrhage (50.0%, p < 0.001 ).Discussion: This work showed a higher mortality rate and neurodevelopment impairment in preterm newborns with severe peri-ventricular haemorrhage. Analysis by groups stratified according to gestational age and different grades of peri-ventricular haemorrhage displayed the complications associated with peri-ventricular haemorrhage grade IV or grade III, with or without cystic peri-ventricular leukomalacia.Conclusion: Preterm newborns with peri-intraventricular haemorrhage grade IV or grade III with cystic peri-ventricular leukomalacia, had a higher risk of mortality and severe neurodevelopmental impairment. |
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Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of AgeHemorragia Peri-Intraventricular Grave em Prematuros: Impacto na Mortalidade e no Neurodesenvolvimento aos 24 MesesBrain/diagnostic imagingCerebral Intraventricular HemorrhageCranial UltrasoundDevelopmental Disabilities/diagnostic imagingInfantVery Low Birth WeightCérebro/diagnóstico por imagemDeficiências do Desenvolvimento/diagnóstico por imagemHemorragia Cerebral IntraventricularRecém-Nascido de Muito Baixo PesoIntroduction: Severe peri-intraventricular haemorrhage has been associated with higher mortality and neurodevelopmental impairment. The impact of peri-intraventricular haemorrhage alone (without white matter injury) remains controversial. The aim of this study was to evaluate the influence of severe peri-intraventricular haemorrhage, associated or not with cystic peri-ventricular leukomalacia, on mortality and neurodevelopment at 24 months.Material and Methods: Retrospective cohort study, that included newborns with severe peri-intraventricular haemorrhage admitted to a maternity hospital with differentiated perinatal support between 2006 and 2015, and two controls with the same gestational age, without peri-intraventricular haemorrhage, who were admitted immediately after the case. Neurodevelopmental assessment, at 24 months, was performed in 99 children, using the Schedule of Growing Skills II scale in 52 and the Ruth Griffiths mental development scale in 47 children. Severe neurodevelopmental deficit was diagnosed in the following conditions: cerebral palsy, delayed psychomotor development, deafness requiring hearing aids and blindness.Results: The study included 41 cases and 82 controls. Out of these, 23 died, 16 (39.0%) in the group of severe peri-intraventricular haemorrhage and seven (8.5%) in the control group (OR 7.6, 95% CI 2.6 - 20.4, p < 0.001). Severe neurodevelopmental deficit was diagnosed in seven (30.4%) in the severe peri-intraventricular haemorrhage group and one (1.3%) in the control group (OR 32; 95% CI 3.7 - 281, p < 0.001). Individualized analysis showed that mortality was higher in peri-intraventricular haemorrhage grade III with associated cystic peri-ventricular leukomalacia (OR 4.4 95% CI 1.3 - 14.2, p = 0.015) and in peri-intraventricular haemorrhage IV (OR 12; 95% CI 3.5 - 41.2, p < 0.001), when compared to controls. Differences were also noticed regarding severe neurodevelopmental deficit when compared with controls (1.3%) in grade III peri-intraventricular haemorrhage with associated cystic peri-ventricular leukomalacia, (75.0%, p < 0.001) and grade IV peri-intraventricular haemorrhage (50.0%, p < 0.001 ).Discussion: This work showed a higher mortality rate and neurodevelopment impairment in preterm newborns with severe peri-ventricular haemorrhage. Analysis by groups stratified according to gestational age and different grades of peri-ventricular haemorrhage displayed the complications associated with peri-ventricular haemorrhage grade IV or grade III, with or without cystic peri-ventricular leukomalacia.Conclusion: Preterm newborns with peri-intraventricular haemorrhage grade IV or grade III with cystic peri-ventricular leukomalacia, had a higher risk of mortality and severe neurodevelopmental impairment.Introdução: A hemorragia peri-intraventricular grave tem sido associada a maior mortalidade e sequelas do neurodesenvolvimento.Mantém-se controverso o impacto da hemorragia peri-intraventricular isolada, sem lesão da substância branca. O objetivo deste trabalho foi avaliar a influência da hemorragia peri-intraventricular grave, associada ou não a leucomalácia peri-ventricular quística, na mortalidade e no neurodesenvolvimento aos 24 meses.Material e Métodos: Estudo de coorte retrospetiva que incluiu os recém-nascidos com hemorragia peri-intraventricular grave, internados numa maternidade de apoio perinatal diferenciado, entre 2006 e 2015, e dois controlos com a mesma idade gestacional, internados logo a seguir ao caso, sem hemorragia peri-intraventricular. A avaliação do neurodesenvolvimento, aos 24 meses, foi realizada em 99 crianças, com recurso à escala The Schedule of Growing Skills Scale II em 52 e à escala de desenvolvimento mental de Ruth Griffiths em 47 crianças. Considerou-se défice grave do neurodesenvolvimento: paralisia cerebral, atraso do desenvolvimento psicomotor, surdez com necessidade de prótese auditiva ou cegueira.Resultados: Foram incluídos 41 recém-nascidos com hemorragia peri-intraventricular grave e 82 controlos. Ocorreram 23 óbitos, 16 (39,0%) nas hemorragias peri-intraventricular graves e sete (8,5%) nos controlos (OR 7,6; IC 95% 2,6 - 20,4; p < 0,001). Verificou-se défice grave do neurodesenvolvimento em sete (30,4%) no grupo de hemorragia peri-intraventricular graves e um (1,3%) no grupo de controlos (OR 32; IC 95% 3,7 - 281; p < 0,001). Na análise individualizada, a mortalidade foi superior quer nas hemorragia peri-intraventricular grau III com leucomalácia peri-ventricular quística associada (OR 4,4 IC 95% 1,3 - 14,2; p = 0,015), quer na hemorragia peri-intraventricular grau IV (OR 12; IC 95% 3,5 - 41,2; p < 0,001), em relação aos controlos. Verificaram-se também diferenças no défice grave do neurodesenvolvimento em relação aos controlos (1,3%) na hemorragia peri-intraventricular grau III com leucomalácia peri-ventricular quística associada (75,0%, p < 0,001) e na hemorragia peri-intraventricular grau IV (50,0%, p < 0,001).Discussão: Este estudo evidenciou maior taxa de mortalidade e de alterações graves do neurodesenvolvimento nos prematuros com hemorragia peri-intraventricular grave. A análise dos grupos estratificados por idade gestacional e a abordagem separada dos vários tipos de hemorragia peri-intraventricular, permitiu evidenciar as complicações associadas à hemorragia peri-intraventriculargrau IV e grau III, associada ou não a leucomalácia peri-ventricular quística.Conclusão: Os recém-nascidos com hemorragia peri-intraventricular de grau IV ou grau III com leucomalácia peri-ventricular quística associaram-se a maior mortalidade e sequelas graves do neurodesenvolvimento.Ordem dos Médicos2022-01-03info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295Acta Médica Portuguesa; Vol. 35 No. 1 (2022): January; 42-50Acta Médica Portuguesa; Vol. 35 N.º 1 (2022): Janeiro; 42-501646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/6183https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/15207https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/11402https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/11423https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/11716https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/12205https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/12363Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessAmaral, JoanaPeixoto, SaraFaria, DoloresResende, CristinaTaborda, Adelaide2023-07-23T03:00:48Zoai:ojs.www.actamedicaportuguesa.com:article/12295Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:10.399586Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age Hemorragia Peri-Intraventricular Grave em Prematuros: Impacto na Mortalidade e no Neurodesenvolvimento aos 24 Meses |
title |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age |
spellingShingle |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age Amaral, Joana Brain/diagnostic imaging Cerebral Intraventricular Hemorrhage Cranial Ultrasound Developmental Disabilities/diagnostic imaging Infant Very Low Birth Weight Cérebro/diagnóstico por imagem Deficiências do Desenvolvimento/diagnóstico por imagem Hemorragia Cerebral Intraventricular Recém-Nascido de Muito Baixo Peso |
title_short |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age |
title_full |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age |
title_fullStr |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age |
title_full_unstemmed |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age |
title_sort |
Survival and Neurodevelopmental Outcomes of Premature Infants with Severe Peri-Intraventricular Hemorrhage at 24 Months of Age |
author |
Amaral, Joana |
author_facet |
Amaral, Joana Peixoto, Sara Faria, Dolores Resende, Cristina Taborda, Adelaide |
author_role |
author |
author2 |
Peixoto, Sara Faria, Dolores Resende, Cristina Taborda, Adelaide |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Amaral, Joana Peixoto, Sara Faria, Dolores Resende, Cristina Taborda, Adelaide |
dc.subject.por.fl_str_mv |
Brain/diagnostic imaging Cerebral Intraventricular Hemorrhage Cranial Ultrasound Developmental Disabilities/diagnostic imaging Infant Very Low Birth Weight Cérebro/diagnóstico por imagem Deficiências do Desenvolvimento/diagnóstico por imagem Hemorragia Cerebral Intraventricular Recém-Nascido de Muito Baixo Peso |
topic |
Brain/diagnostic imaging Cerebral Intraventricular Hemorrhage Cranial Ultrasound Developmental Disabilities/diagnostic imaging Infant Very Low Birth Weight Cérebro/diagnóstico por imagem Deficiências do Desenvolvimento/diagnóstico por imagem Hemorragia Cerebral Intraventricular Recém-Nascido de Muito Baixo Peso |
description |
Introduction: Severe peri-intraventricular haemorrhage has been associated with higher mortality and neurodevelopmental impairment. The impact of peri-intraventricular haemorrhage alone (without white matter injury) remains controversial. The aim of this study was to evaluate the influence of severe peri-intraventricular haemorrhage, associated or not with cystic peri-ventricular leukomalacia, on mortality and neurodevelopment at 24 months.Material and Methods: Retrospective cohort study, that included newborns with severe peri-intraventricular haemorrhage admitted to a maternity hospital with differentiated perinatal support between 2006 and 2015, and two controls with the same gestational age, without peri-intraventricular haemorrhage, who were admitted immediately after the case. Neurodevelopmental assessment, at 24 months, was performed in 99 children, using the Schedule of Growing Skills II scale in 52 and the Ruth Griffiths mental development scale in 47 children. Severe neurodevelopmental deficit was diagnosed in the following conditions: cerebral palsy, delayed psychomotor development, deafness requiring hearing aids and blindness.Results: The study included 41 cases and 82 controls. Out of these, 23 died, 16 (39.0%) in the group of severe peri-intraventricular haemorrhage and seven (8.5%) in the control group (OR 7.6, 95% CI 2.6 - 20.4, p < 0.001). Severe neurodevelopmental deficit was diagnosed in seven (30.4%) in the severe peri-intraventricular haemorrhage group and one (1.3%) in the control group (OR 32; 95% CI 3.7 - 281, p < 0.001). Individualized analysis showed that mortality was higher in peri-intraventricular haemorrhage grade III with associated cystic peri-ventricular leukomalacia (OR 4.4 95% CI 1.3 - 14.2, p = 0.015) and in peri-intraventricular haemorrhage IV (OR 12; 95% CI 3.5 - 41.2, p < 0.001), when compared to controls. Differences were also noticed regarding severe neurodevelopmental deficit when compared with controls (1.3%) in grade III peri-intraventricular haemorrhage with associated cystic peri-ventricular leukomalacia, (75.0%, p < 0.001) and grade IV peri-intraventricular haemorrhage (50.0%, p < 0.001 ).Discussion: This work showed a higher mortality rate and neurodevelopment impairment in preterm newborns with severe peri-ventricular haemorrhage. Analysis by groups stratified according to gestational age and different grades of peri-ventricular haemorrhage displayed the complications associated with peri-ventricular haemorrhage grade IV or grade III, with or without cystic peri-ventricular leukomalacia.Conclusion: Preterm newborns with peri-intraventricular haemorrhage grade IV or grade III with cystic peri-ventricular leukomalacia, had a higher risk of mortality and severe neurodevelopmental impairment. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-03 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/6183 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/15207 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/11402 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/11423 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/11716 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/12205 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12295/12363 |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa |
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openAccess |
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application/pdf application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document application/msword application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 35 No. 1 (2022): January; 42-50 Acta Médica Portuguesa; Vol. 35 N.º 1 (2022): Janeiro; 42-50 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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