Study Of Periventricular-intraventricular Hemorrhage And The Related Influence Factors In Premature Infants

Objective:Conduct the retrospective analysis to research the incidence of Periventricular-intraventricular hemorrhage（PIVH）in preterm infants,and investigate the potential related factors;discuss the measures to prevent the occurrence of PIVH and reduce brain damage of infants,and search the reference to improve the prognosis of PIVH.Methods:A retrospective analysis of the clinical data of 292 premature infants admitted to the Neonatal Intensive Care Unit（NICU）of Dalian Women And Children Medical Center from January 2019 to December 2019.All premature infants were less than 7 days old.According to the result of cranial ultrasound,the premature infants can be devided into PIVH group and non-PIVH group.According to the Papile classification,PIVH can be divided into 4 grades.Gather the data of observation indicators,such as General informations:gender,gestational age,birth weight and multiple births,etc;Prenatal factors:pregnancy complications,premature rupture of membranes,abnormal amniotic fluid,abnormal placenta,abnormal umbilical cord,etc.;Postpartum factors:asphyxia,mechanical ventilation,hypoglycemia,acidosis,etc.Compare PIVH and non-PIVH groups with univariate analysis.For the observation indicators with statistical significance,a multivariate logistic regression analysis will be performed to explore the correlation between PIVH and the observation indicators in premature infants.Results:A total of 292 premature infants were observed in this study.The gestational age at birth was distributed from 27⁺³to 36⁺⁶weeks,and the average gestational age was 34.0±2.2 weeks;the birth weight was distributed from 1035-3500g,and the average birth weight was 2100.42±423.68 g.Including 156 male preterm infants,,and 136 female preterm infants,The male to female ratio is 1.1:1.75 premature infants with PIVH,the incidence was 25.7%,including 66 infants with mild PIVH and 3infants with severe PIVH.The average gestational age at birth of PIVH group was 32.3±1.8 weeks,while the average gestational age of non-PIVH group was 34.1±2.1weeks,the difference between the two groups was statistically significant（P<0.05）.The average birth weight of the PIVH group was 2100.42±423.68g,while the average birth weight of the non-PIVH group was 1962.69±416.68g,the difference was statistically significant（p<0.05）.Among the factors which were prenatal or during the delivery,cesarean section,abnormal amniotic fluid,and premature rupture of membranes were significantly different between the PIVH group and the non-PIVH group（p<0.05）.Among the postpartum related factors:premature infants with acidosis,hypercapnia,hypoxemia,RDS,or mechanical ventilation duration over 7 days were obviously different with statistical significance（p<0.05）.The results of multivariate analysis showed that gestational age,birth weight and cesarean section are protective factors for PIVH.The older the gestational age is,the heavier the birth weight is,the lower,the incidence of PIVH is.While the abnormal amniotic fluid volume and hypoxemia are independent risk factors for PIVH.Conclusion:1.The incidence of PIVH in premature infants is 25.7%.2.The factors including gestational age,birth weight,cesarean section, abnormal amniotic fluid volume,premature rupture of membranes,acidosis, hypercapnia,hypoxemia,RDS,mechanical ventilation duration over 7 day,etc,have the potential correlation with PIVH.3.We find that gestational age,birth weight and cesarean section are the protective factors against PIVH,while Abnormal amniotic fluid during pregnancy and hypoxemia after birth will increase the incidence of PIVH in preterm infants.