Neurodevelopmental impairment in preterm infants following progressive post-hemorrhagic ventricular dilatation.

OBJECTIVE

To investigate the relationship of post-hemorrhagic ventricular dilatation (PHVD) with neurodevelopmental outcomes in preterm infants.

STUDY

DESIGN

Retrospective cohort study of infants <29 weeks' gestation admitted from 2010-2018 with intraventricular hemorrhage and neurodevelopmental assessment at 18-21 months corrected age. Eligible infants were grouped as 'no PHVD', 'PHVD without neurosurgical intervention', and 'symptomatic PHVD with intervention'. Neurodevelopmental impairment (NDI) was assessed using generalized linear models.

RESULTS

Of 227 infants, 183 (80.6%) had no PHVD, 28 (12.3%) had PHVD without intervention, and 16 (7.0%) had PHVD with intervention. Severe NDI was observed in 14 (7.7%), 10 (35.7%), and 10 (62.5%) infants, respectively (p < 0.05). PHVD without and with intervention was associated with significantly increased risk of overall NDI (adjusted odds ratios [aOR] 6.2, 95% CI 2.4-16.5 and 18.1, 95% CI 5.5-68.4) as compared to no PHVD.

CONCLUSIONS

Progressive PHVD, irrespective of clinical symptoms, predisposes affected preterm infants to significant risk of NDI.