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Open Access 01-12-2020 | Original Article

Reduction of severe intraventricular hemorrhage, a tertiary single-center experience: incidence trends, associated risk factors, and hospital policy

Authors: Wafa Sattam M. Alotaibi, Nada S. Alsaif, Ibrahim A. Ahmed, Aly Farouk Mahmoud, Kamal Ali, Abdullah Hammad, Omar S. Aldibasi, Saif A. Alsaif

Published in: Child's Nervous System | Issue 12/2020

Abstract

Objectives

To determine the incidence, trends, maternal and neonatal risk factors of severe intraventricular hemorrhage (IVH) among infants born 24–32 weeks and/or < 1500 g, and to evaluate the impact of changing of hospital policies and unit clinical practice on the IVH incidence.

Study design

Retrospective chart review of preterm infants with a gestational age (GA) of 24–32⁶ weeks and/or weight of < 1500 g born at King Abdulaziz Medical City–Riyadh (KAMC-R), Saudi Arabia, from 2016 to 2018. Multivariate logistic regression model was constructed to determine the probability of developing severe IVH and identify associations with maternal and neonatal risk factors.

Results

Among 640 infants, the overall incidence of severe IVH was 6.4% (41 infants), and its rate decreased significantly, from 9.4% in 2016 to 4.5% and 5% in 2017 and 2018 (p = 0.044). Multivariate analysis revealed that caesarian section delivery decreased the risk of severe IVH in GA group 24–27 weeks (p = 0.045). Furthermore use of inotropes (p = 0.0004) and surfactant (p = 0.0003) increased the risk of severe IVH. Despite increasing use of inotropes (p = 0.024), surfactant therapy (p = 0.034), and need for delivery room intubation (p = 0.015), there was a significant reduction in the incidence of severe IVH following the change in unit clinical practice and hospital policy (p = 0.007).

Conclusion

Cesarean section was associated with decreased all grades of IVH and severe IVH, while use of inotropes was associated with increased severe IVH. The changes in hospital and unit policy were correlated with decreased IVH during the study period.

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Title: Reduction of severe intraventricular hemorrhage, a tertiary single-center experience: incidence trends, associated risk factors, and hospital policy
Authors: Wafa Sattam M. Alotaibi
Nada S. Alsaif
Ibrahim A. Ahmed
Aly Farouk Mahmoud
Kamal Ali
Abdullah Hammad
Omar S. Aldibasi
Saif A. Alsaif
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 12/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04621-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Reduction of severe intraventricular hemorrhage, a tertiary single-center experience: incidence trends, associated risk factors, and hospital policy

Abstract

Objectives

Study design

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Study design

Results

Conclusion

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