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RISK FACTORS FOR INTRAVENTRICULAR HEMORRHAGE IN VERY AND EXTREMELY LOW BIRTH WEIGHT PREMATURE NEONATES
*Rahaf Dayoub and Oday Jouni
Background: Intraventricular hemorrhage (IVH) remains a common and severe complication in premature infants with poor outcome, especially in severe cases. Objective: The aim of this study is to evaluate the risk factors that associated with occurrence of IVH. Materials and Methods: An observational prospective cohort study was conducted for the period two years (2020 and 2021) at Tishreen University Hospital in Lattakia-Syria. The study included two groups of premature neonates were compared: group I consisted of 31 neonates with a diagnosis of IVH(cases), whereas group II consisted of 84 neonates without IVH(controls). Results: The results showed that 26.95% of the study population had IVH, including 42% 0f mild grade and 58% of severe grade. IVH occurred during 72 hours after birth in 71% and after 3 days in 29%. The prevalence of IVH was increased significantly with decreasing of gestational age (p:0.006), birth weight (p:0.0001), Apgar score(p:0.0001), and non- using corticosteroid in the perinatal period (p:0.007). Post-natal factors that associated significantly with IVH were: need for mechanical ventilation, pneumothorax, hyaline membrane disease, PDA, hyperglycemia, acidosis, using of inotropic drugs, and septicemia(p<0.05). Gestational age <28 week (RR 3.3), birth weight <1000 g (RR 4.5), presence of PDA (RR 8.2), acidosis (RR 10.7), pneumothorax (RR 7.3), hyperglycemia (RR 7.5), and mechanical ventilation (RR 3.9) were independent factors that associated with the risk of progression IVH. Conclusion: There is an important prevalence of IVH in our health center, and presence of extremely prematurity with acidosis, pneumothorax, hyperglycemia, PDA, and mechanical ventilation are all warning flags that may predispose to IVH.[Full Text Article]