Temporal trends in intraventricular hemorrhage in preterm infants: A Brazilian multicenter cohort

• Autor(a) principal: de Figueiredo Vinagre, Luís Eduardo
• Data de Publicação: 2022
• Outros Autores: de Siqueira Caldas, Jamil Pedro, Martins Marba, Sergio Tadeu, Procianoy, Renato Soibelmann, de Cássia Silveira, Rita, Santiago Rego, Maria Albertina, de Lima Mota Ferreira, Daniela Marques, Sales Alves Junior, José Mariano, dos Santos, Juliana Paula Ferraz, Gimenes, Carolina Boschi, de Mello e Silva, Nathalia Moura, Conde Gonzalez, Maria Rafaela, da Silva, Regina Paula Guimaraes Vieira Cavalcante, do Amaral Gomez, Dafne Barcala Coutinho, do Vale, Marynea Silva, de Souza Rugolo, Lígia Maria Suppo [UNESP], Meneguel Ogata, Joice Fabiola, de Albuquerque Diniz, Edna Maria, Luz, Jorge Hecker, de Almeida, Joao Henrique Carvalho Leme, de Souza, Márcia Pereira Alves, Goncalves Ferri, Walusa Assad
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1016/j.ejpn.2022.05.003; http://hdl.handle.net/11449/241192
• topic: Corticosteroids; Intraventricular hemorrhage; Multicenter study; Outcome assessments; Premature infant

Background: Intraventricular hemorrhage (IVH) is a serious problem in preterm infants. Brazilian national data are unknown. Objective: To evaluate the incidence and temporal trend of IVH in very low birth weight (VLBW) preterm infants of 18 centers of the Brazilian Network on Neonatal Research. Study design: National prospective multicenter cohort study including inborn VLBW preterm infants aged 230/7- 336/7 weeks’ gestation, admitted between 2013 and 2018. The center with the mean incidence rate was used as reference. We applied two adjustments models using perinatal variables, and perinatal + neonatal diseases. Results: Of 6,420 infants, 1951/30.4% (range 27.1–33.8%) had IVH and the disease showed a significant trend towards an overall increase in incidence over time (p = 0.003), especially in three centers. Severe IVH (grade III or IV) occurred in 32.2% (range 29.2–34.5%) of those affected by IVH, with a stable incidence. After adjustments for perinatal variables, the differences persisted among centers: for global IVH, 7 centers had significantly lower rates (OR ranging from 0.31 to 0.62), and 2 presented rates higher than the reference center (OR ranging from 2.00 to 12.46) for severe HIV. Considering perinatal and neonatal variables, 6 centers had significantly lower rates (OR ranging from 0.36 to 0.60) for global IVH than the reference center and 3 had statistically higher rates (OR 1.72, 1.86 and 11.78) for severe forms. Conclusion: The incidence rate of IVH in this Brazilian cohort was high and it revealed an increasing trend towards over time. The severe IVH rate was also worrisome.