Association between middle cerebral artery doppler flow parameters and intraventricular hemorrhage in preterm infants.

PURPOSE: To evaluate whether middle cerebral artery (MCA) Doppler flow parameters measured in the first week of life are associated with intraventricular hemorrhage (IVH) in preterm infants.

METHODS

A prospective cohort study was conducted in a level 4A neonatal intensive care unit (NICU) at Adana City Training and Research Hospital between March 2022 and April 2023. Preterm infants born weighing ≤1250 g and ≥500 g were included. MCA flow parameters, including peak systolic velocity (PSV), peak diastolic velocity (PDV), pulsatility index (PI), resistivity index (RI) and time-averaged maximum velocity (TAMAX) were measured via transfontanel Doppler ultrasonography within the first five days of life every day. The association between MCA Doppler parameters and IVH development was analyzed.

RESULTS

Ninety-two preterm infants were included. IVH was detected in 34.7% (n = 32). Infants with IVH had lower gestational age and birth weight. Logistic regression revealed that lower birth weight, the presence of PDA, and early-onset sepsis increased IVH risk. Both increased and decreased MCA Doppler parameters (PSV, PDV, PI and TAMAX) preceded IVH.

CONCLUSION

MCA Doppler flow fluctuations were associated with IVH in preterm infants. These associations warrant further investigation to determine whether MCA Doppler measurements can prospectively identify infants at risk for IVH.

WHAT IS KNOWN: Cerebral autoregulation is a developmental process that can be disrupted in neonates with congenital heart disease, hypoxic-ischemic encephalopathy, and those born preterm.

WHAT IS NEW: Novel methods to assess cerebral autoregulation in these populations can be used to target patient-specific hemodynamic parameters.