Abstract:
Background: Intraventricular hemorrhage (IVH) is one of the most common types of brain injury in preterm infants, which affects 15-20%, with potential long-term adverse neurodevelopmental outcomes.1 The pathogenesis of IVH is attributed to intrinsic fragility of germinal matrix vasculature and to fluctuation in the cerebral blood flow.2 The purpose of this study is to identify the risk factors for IVH in preterm infants.
Materials and methods: We searched PubMed, Embase, and Web of Science literature databases using keywords: “risk factor" AND "intraventricular" OR "periventricular" OR "peri-intraventricular" OR "subependymal" OR "germinal matrix" OR "cerebroventricular" AND "preterm neonate" from inception to October 2024. The meta-analysis included all published studies that investigated preterm infants and reported primary data that could be used to measure the association between risk factors and the presence of IVH. Odds ratios (ORs) for each risk factor were pooled from the selected studies. For each potential risk factor, the fixed or random-effects model was used to compare the risk of developing IVH.
Results: A total of 285 records were identified, of which 15 studies were eligible. The findings of the meta-analysis showed that lower gestational age, asphyxia, neonatal infection, and mechanical ventilation exposure were significantly associated with all grades IVH (OR 1.92, 95% CI 1.61– 2.30; OR 2.78, 95% CI 1.87–4.12; OR 2.46, 95% CI 2.14–2.81; OR 2.51, 95% CI 1.97–3.20). The results of the meta-analysis also showed pooled odds ratio was 0.92, 95% CI 0.74–1.14 for the effect of MgSO4 on IVH. Infants whose mother had been given full course of antenatal steroids (OR 0.32, 95% CI 0.21-0.49) had a significantly lower risk of developing IVH.
Conclusion: Lower gestational age, asphyxia, neonatal infection, and mechanical ventilation were associated with an increased risk of IVH, whereas full course of antenatal steroids had a protective role against developing IVH.
Funding Statements: This research was supported by Indonesia Endowment Fund for Education Agency
