Correlation Analysis Of Hemodynamic Parameters And Intracranial Hemorrhage In Term And Late Preterm Infants

Objective The purpose of this study is to analyze the hemodynamic parameters of intracranial hemorrhage in term infants and premature infants,and to explore the correlation between hemodynamic parameters and intracranial hemorrhage in term infants and late preterm infants.Methods We retrospectively analyzed the medical records of late preterm infant admitted to NICU in Children’s Hospital of Chongqing Medical University from September 2017 to October 2019.Infants with intracranial hemorrhage belonged to the ICH group.Children with no intracranial hemorrhage were taken as the control group.Both groups were monitored at the bedside with a non-invasive cardiac output measuring instrument after receiving NICU to collect indicators such as heart rate(HR),mean arterial pressure(MAP),minute distance(MD),cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke volume index(SVI),corrected flow time(FTc),and systemic vascular resistance index(SVRI).The hemodynamic indexes of the intracranial hemorrhage group and the control group were analyzed by T-test or Chi-square test.Multivariate logistics regression analysis was used to explore the correlation between hemodynamic parameters and intracranial hemorrhage in late preterm infants and term infants.Results A total of 110 neonates were included in our study,including 54 term infants and 27 intracranial hemorrhage;58 late preterm infants and 28 intracranial hemorrhage.There was no significant difference between the two groups of infants in maternal diseases,gender,gestational age,birth weight,birth pattern,antenatal use of corticosteroid and other general conditions(P>0.05).Compared with the control group,there were statistically significant differences in heart rate,diastolic blood pressure,peripheral vascular resistance index,systolic blood pressure <60mm Hg,anemia,blood transfusion,and fetal distress in infants with intracranial hemorrhage in late preterm term infants(P<0.05).There were statistically significant differences in HR,MD,SV,SVI,CO,CI,SVRI,5-minute Apgar score between the two groups of term infants(P<0.05).The results of multivariate analysis showed that :(1)fetal distress,anemia,systolic blood pressure <60mm Hg,heart rate were related to intracranial hemorrhage in late preterm infants;with OR values of 28.913(95%CI 2.514~332.532),6.174(95%CI 1.067~35.732),5.882(95%CI 1.273~27.173),1.057(95%CI 1.01~1.107).(2)MD、FTc were related to intracranial hemorrhage in term infants;with OR values of 0.722(95%CI 0.594~0.877),1.036(95%CI 1.009~1.064).Conclusion In our study,late preterm infants with increased heart rate and hypotension had a higher incidence of intracranial hemorrhage;Term infants with smaller increasing range in MD had a lower incidence of intracranial hemorrhage,while the incidence of intracranial hemorrhage is higher when FTc is longer.Maintaining the relative stability of the above hemodynamic parameters helps reduce the incidence of intracranial hemorrhage.