PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 25 Original Article Kulkarni PP, et al. Assessment of Risk Factors of Intraventricular Hemorrhage Among Preterm Neonates Limitations The limitations of our study were that CT and MRI could not be done in all the neonates and other types of hemorrhage such as subdural hemorrhage, extradural hemorrhage, and intraparenchymal hemorrhage could not be evaluated. Conclusion In our study, it was observed that most of the neonates had IVH on day 3 of life, and most of these neonates were asymptomatic. Multiple pregnancy, resuscitation at birth, male sex, and low gestational age were proven to be the risk factors. Use of antenatal steroids and LSCS had a protective effect against IVH. Also, cranial ultrasound is an important modality in diagnosing IVH in preterm neonates and also stands as a baseline for further follow-up for long-term sequelae. Acknowledgment We thank all the NICU staff of SDM College of Medical Sciences and Hospital for their help and support. References 1. Cloherty JP, et al. Manual of Neonatal Care. 7th ed. Philadelphia, PA: Lippincott Williams &Wilkins; 2012:687–706. 2. Kliegman R, Behrman R, NelsonW. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:835–836. 3. Sherman NH, et al. Ultrasound essential for imaging neonatal brains. Diagn Imag. 1994;16:108–115. 4. Rumack CM, et al. Timing and course of neonatal intracranial hemorrhage using real time ultrasound. Radiology. 1985;154(1):101–105. 5. Linder N, et al. Risk factors for intraventricular hemorrhage in very low birth weight premature infants: a retrospective case-control study. Pediatrics. 2003;111(5 Pt 1):e590–e595. 6. Kurtz BA. Ultrasound measurements of the central nervous system. In: Goldberg BB, et al, eds. Atlas of Normal Ultrasound Measurements. Chicago, IL: Year Book Medical Publishers; 1990. 7. Lopez AD, et al, eds. Global Burden of Disease and Risk Factors. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; New York: Oxford University Press; 2006. 8. Kwesigabo G, Manji KP, Swai PM. Periventricular leucomalacia/intraventricular haemorrhage among very low birth weight infants at Muhimbili National hospital (MNH); Dar-esSalaam; Tanzania. Tanzan Med J. 2005;20(1):5–10. 9. Åhman E, Zupan J. Neonatal and Perinatal Mortality. Geneva, Switzerland: World Health Organization; 2004. https://apps. who.int/iris/bitstream/handle/10665/43800/9789241596145_ eng.pdf?sequence=1&isAllowed=y.Accessed May 22, 2023. 10. Mohamed MA, Aly H. Male gender is associated with intraventricular hemorrhage. Pediatrics. 2010;125(2):e333–e339. 11. Ment LR, et al. Risk factors for early intraventricular hemorrhage in low birth weight infants. J Pediatr. 1992;121(5 Pt 1):776–783. 12. Pekcevik Y, et al. Risk factors of germinal matrix intraventricular hemorrhage in premature infants. Iran J Pediatr. 2014;24(2):191–197. 13. Kari MA, et al. Prenatal dexamethasone treatment in conjunction with rescue therapy of human surfactant: a randomized placebo-controlled multicenter study. Pediatrics. 1994;93(5):730–736. 14. Aly H, et al. Is mechanical ventilation associated with intraventricular hemorrhage in preterm infants? Brain Dev. 2012;34(3):201–205. 15. Vermeulen GM, et al. Perinatal risk factors for cranial ultrasound abnormalities in neonates born after spontaneous labour before 34 weeks. Eur J Obstet Gynecol Reprod Biol. 2001;94(2):290–295. 16. Vural M, et al. Intraventricular hemorrhage in preterm newborns: risk factors and results from a University Hospital in Istanbul, 8 years after. Pediatr Int. 2007;49(3):341–344. 17. Bassan H, et al. Ultrasonographic features and severity scoring of periventricular hemorrhagic infarction in relation to risk factors and outcome. Pediatrics. 2006;117(6):2111–2118. Authors’ Affiliations Dr Poornima Prakash Kulkarni, Professor; Dr Kathagaram Vijayasree, Junior Resident; Dr Kavita Shantmallappa Konded, Professor; Dr Vijay Keshavarao Kulkarni, Professor and Head, Department of Pediatrics, Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Sattur, Dharwad 580009, Karnataka, India
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