Neonatal intracranial hemorrhage: II. Risk factor analysis in an inborn population

Lawrence A. Wallin, Charles R. Rosenfeld, Abbot R. Laptook, Ann M. Maravilla, Cynthia Strand, Nancy Campbell, Sharon Dowling, Robert E. Lasky

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Abstract

The ability to predict the occurrence of neonatal periventricular-intraventricular hemorrhage (PVH-IVH) would be useful in the design of clinical trials to prevent its occurrence. Therefore, data were collected from 463 consecutive infants ≤1500 g birth weight delivered between March 1, 1982 and February 28, 1985. This large population made it feasible to divide the infants into two groups, using one group to develop a model predictive of ICH and the second group to test the validity of the model. Infants were randomly grouped by sex, race, gestational age, birth weight, month of birth, mortality, and incidence and grade of worst PVH-IVH. In Group A (n = 232), respiratory distress syndrome, ventilator therapy, PaCO2 ≥ 60 mmHg, Po2 ≤ 40 mmHg ≥ 2 h, lower 1- and 5-min Apgar scores, lower pediatric estimation of gestational age, and pneumothorax were significantly associated with PVH-IVH by univariant analyses (χ2, P < 0.03). Multivariant discriminant analysis performed on Group A revealed that pneumothorax, cesarean section, PaCO2, and ventilator therapy were most predictive of PVH-IVH, but sensitivity was 55% and specificity 78%. Applying the model to Group B, sensitivity decreased to 21% while specificity rose to 93%. Logistic regression, which takes into account non-normally distributed variables, did not improve predictability. Although the clinical factors associated with the occurrence of PVH-IVH in our large inborn population of low-birth-weight infants do not differ from earlier reports, we were unable to develop an adequate model predictive for PVH-IVH. Thus, many of these factors may be associations rather than causative.

Original languageEnglish (US)
Pages (from-to)129-137
Number of pages9
JournalEarly Human Development
Volume23
Issue number2
DOIs
StatePublished - 1990

Fingerprint

Intracranial Hemorrhages
Statistical Factor Analysis
Pneumothorax
Mechanical Ventilators
Birth Weight
Gestational Age
Population
Apgar Score
Low Birth Weight Infant
Discriminant Analysis
Cesarean Section
Logistic Models
Clinical Trials
Parturition
Pediatrics
Hemorrhage
Mortality
Incidence
Therapeutics

Keywords

  • low-birth-weight
  • periventricular-intraventricular hemorrhage
  • risk factors
  • sonography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Wallin, L. A., Rosenfeld, C. R., Laptook, A. R., Maravilla, A. M., Strand, C., Campbell, N., ... Lasky, R. E. (1990). Neonatal intracranial hemorrhage: II. Risk factor analysis in an inborn population. Early Human Development, 23(2), 129-137. https://doi.org/10.1016/0378-3782(90)90136-7

Neonatal intracranial hemorrhage : II. Risk factor analysis in an inborn population. / Wallin, Lawrence A.; Rosenfeld, Charles R.; Laptook, Abbot R.; Maravilla, Ann M.; Strand, Cynthia; Campbell, Nancy; Dowling, Sharon; Lasky, Robert E.

In: Early Human Development, Vol. 23, No. 2, 1990, p. 129-137.

Research output: Contribution to journalArticle

Wallin, LA, Rosenfeld, CR, Laptook, AR, Maravilla, AM, Strand, C, Campbell, N, Dowling, S & Lasky, RE 1990, 'Neonatal intracranial hemorrhage: II. Risk factor analysis in an inborn population', Early Human Development, vol. 23, no. 2, pp. 129-137. https://doi.org/10.1016/0378-3782(90)90136-7
Wallin, Lawrence A. ; Rosenfeld, Charles R. ; Laptook, Abbot R. ; Maravilla, Ann M. ; Strand, Cynthia ; Campbell, Nancy ; Dowling, Sharon ; Lasky, Robert E. / Neonatal intracranial hemorrhage : II. Risk factor analysis in an inborn population. In: Early Human Development. 1990 ; Vol. 23, No. 2. pp. 129-137.
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