Prevalence and risk factors for Intraventricular Haemorrhage and Periventricular Leukomalacia in very low birth weight infants at Rahima Moosa Mother and Child Hospital

Abstract

Background: Intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL) are major causes of mortality and morbidity in very low birth weight (VLBW) infants. The prevalence and risk factors for IVH and PVL vary between institutions.

Objectives: To determine the prevalence of IVH and PVL in premature infants with a birth weight of <1 500 g at RMMCH. To compare the risk factors and characteristics for IVH and PVL.

Method: This was a retrospective cross-sectional study of infants <1 500 g admitted between the 1 st November 2018 and 31st October 2019 at RMMCH. Characteristics of infants with cranial ultrasound or MRI abnormalities were compared to infants with normal cranial imaging.

Results: A total of 432 VLBW infants were screened for inclusion into the study, 30% (128/432) were excluded due to absence of cranial imaging, transfer to other hospitals or early death. The final sample size was 304 infants. IVH was present in 40% (n=122; 95% CI 34.6-45.7). Independent risk factors for IVH were patent ductus arteriosus (p=0.03), metabolic acidosis on the first arterial blood gas (p<0.001) and lack of antenatal booking (p=0.004). Severe IVH was present in 12% (n=37; 95% CI, 8.5-16) of infants. The rate of PVL was 0.3% (n=1; 95% CI 0-0.98)

Conclusion: The prevalence of any IVH in VLBW infants at RMMCH is comparable to that of developing countries. Risk factors were like those described in other centers. Availability of MRI would assist in delineating the extent of PVL in VLBW infants at our centre