关键词: 脑出血, 脑室, 婴儿, 早产, 婴儿, 极低出生体重, 分娩, 糖皮质激素类, 脑室内出血

Abstract: Objective To analyze the related factors of intraventricular hemorrhage (IVH) in very low birth weight premature infants and to improve the survival rate and quality of life. Methods A retrospective analysis of 421 very low birth weight premature infants admitted to the neonatal intensive care unit of Tianjin Central Hospital of Gynecology and Obstetrics from July 2017 to July 2019 was conducted, including their gestational age, gender, delivery mode, birth weight, head ultrasound result, maternal pregnancy complications (maternal pregnancy with hypertension, thyroid dysfunction, gestational diabetes mellitus, premature rupture of membranes, chorioamnionitis and the antenatal use of glucocorticoids) and perinatal conditions (whether Apgar score 5 minutes after birth was ≤ 7, and whether there was sepsis, hemorrhagic disease, patent ductus arteriosus or invasive mechanical when the ultrasound examination was conducted within 72 hours after birth). On this basis, we analyzed the related factors of intraventricular hemorrhage and its severity. Results Compared with the non-IVH group, the proportion of infants with gestational age ≤28 weeks, birth weight≤1 000 g, 5 min Apgar score after birth ≤7, history of septicemia and history of invasive mechanical ventilation were significantly higher in the IVH group, the proportion of maternal pregnancy with hypertension was significantly lower (all P<0.05). Binary Logistic regression analysis showed that 5 min Apgar score after birth≤7 (OR=2.273, 95%CI: 1.163-4.442) and vaginal delivery (OR= 2.727, 95%CI: 1.522-4.885) were the independent risk factors for intraventricular hemorrhage. Compared with the nonsevere IVH group, the proportion of infants with gestational age ≤28 weeks, birth weight≤1 000 g, 5 min Apgar score after birth ≤7, history of septicemia were higher in the severe IVH group, while the proportion of antenatal use of glucocorticoids was lower (all P＜0.05). Conclusion The effective resuscitation and appropriate delivery mode can effectively reduce the incidence of intraventricular hemorrhage in very low birth weight premature infants, and the antenatal use of glucocorticoids can reduce the occurrence of severe intraventricular hemorrhage.

Key words: cerebral hemorrhage, cerebral ventricles, infant, premature, infant, very low birth weight, parturition, glucocorticoids, intraventricular hemorrhage