Transport-Related Risk Factors for Intraventricular Hemorrhage in Preterm Neonates: An Exploratory Analysis.

UNLABELLED: Preterm neonates face unique risks during ground transport due to environmental factors and the urgent need for critical interventions. Neuroprotection during transport is essential to safeguard this vulnerable population from developing intraventricular hemorrhage (IVH). Despite efforts to optimize neonatal transport practices, specific transport-related factors contributing to IVH remain poorly understood.

OBJECTIVES

The study aims to identify transport-related factors contributing to IVH, including 1) the association between critical ground transport (miles loaded, time, infant securement) and clinical factors of IVH (hypotension, intubation, etc.) and 2) the impact of maternal and fetal factors on IVH development, including maternal infection, pre-delivery medication administration, Apgar score, respiratory support changes, and hypoxic events.

METHOD: A retrospective design was used, gathering data from the electronic health records of 2 transport teams in the Midwest. Logistic regression models were used to identify transport and maternal variables associated with IVH development.

RESULTS

Among the 79 neonates included in this study, 25 (31.6%) developed IVH. Data indicate a higher incidence of IVH in male neonates (P = .02). Furthermore, maintaining the patient in a midline position was associated with IVH status (P = .03). However, no association was found between critical ground transport and IVH rates. Maternal infection was associated with IVH (B = 1.82, standard error = 0.833, odds ratio = 6.17, 95% confidence interval: 1.30-37.5, P = .0288).

CONCLUSION

Findings underscore the need to optimize ground transport practices, particularly for male neonates, highlighting midline positioning and maternal infections as modifiable factors in IVH prevention.