Intracranial hemorrhage in premature infants: investigation of etiology and mortality

Authors : Özlem Şahin, Derya Çolak, Funda Yavanoğlu Atay, Ömer Güran, Fatma İyigün, Sevinç Taşar, İlke Mungan Akın

Pages : 761-770

Doi:10.31362/patd.1700425

View : 53 | Download : 157

Publication Date : 2025-10-01

Article Type : Research Paper

Abstract :Purpose: Advancements in neonatal care have increased the survival rates of premature infants, but intracranial hemorrhage (ICH) continues to be a concerning issue in neonatal intensive care units (NICU). This study sought to evaluate the risk factors associated with ICH in preterm infants born before 29 weeks of gestation, with a particular focus on the preventive measures. Materials and methods: In a perinatology center with a 61-bed level-4 unit, this retrospective cohort study was conducted in the neonatal intensive care unit. Digital hospital records were scanned for infants born ≤290/7 weeks and hospitalized between 2021-2023. We categorized the study population into three groups based on the increasing severity of ICH according to the first week transfontanelle ultrasonography findings. Demographic, perinatal characteristics, cord blood gas values, platelet count, platelet mass were recorded as laboratory parameters. Clinical interventions, follow-up data and transfusion of blood products, mechanical ventilation requirements, inotrope use within the first 72 hours, length of hospital stay, mortality data were recorded. Results: A total of 96 patients (female/male: 39/57) were enrolled in the study. A significant difference in mean gestational age was observed among patients in Group 1 (no-ICH, n=50), Group 2 (mild, n=25), and Group 3 (severe, n=21) (p<0.001). Additionally, antenatal corticosteroid therapy was notably less frequent in Groups 2 and 3 (p=0.044). Cord lactate and the rate of metabolic acidosis were significantly higher in Group 3 (p=0.026, <0.001). The platelet count and platelet mass were significantly lower in Group 3 compared to the other two groups (p=0.014, p=0.023). Conclusion: Our findings emphasize reduced antenatal corticosteroid use, higher metabolic acidosis rates, increased transfusion needs, and lower platelet mass as prominent risk factors, reaffirming the multifactorial nature of ICH. We believe these measures can be integrated into clinical protocols within the framework of an \\\'\\\'ICH prevention bundle\\\'\\\'.
Keywords : Yenidoğan, intrakraniyal kanama, prematürite, trombosit kütlesi

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