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Am J Perinatol 2018; 35(11): 1087-1092
DOI: 10.1055/s-0038-1641589
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preterm Pulmonary Hemorrhage Is Associated with Multiple Births but Not with Intracytoplasmic Sperm Injection: A Cohort Study on Medical Records

Stefanie Stierling
1   Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Aachen, Germany
,
Ralf-Dieter Hilgers
2   Institute for Medical Statistics, RWTH Aachen University, Aachen, Germany
,
Sonja Trepels-Kottek
1   Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Aachen, Germany
,
Konrad Heimann
1   Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Aachen, Germany
,
Thorsten Orlikowsky
1   Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Aachen, Germany
,
Mark Schoberer
1   Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Aachen, Germany
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Publikationsverlauf

15. November 2017

26. Februar 2018

Publikationsdatum:
10. April 2018 (online)

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Abstract

Objective Pulmonary hemorrhage (PH) is a severe complication in preterm neonates. This study aims to identify risk factors and comorbidities of PH.

Study Design A single-center cohort study on medical records including all preterm neonates of <30 weeks' gestational age was conducted in the neonatal intensive care unit of Universitätsklinikum Aachen, Germany. The occurrence of PH served as a primary end point. Gestational age, birthweight, sex, multiple births, intracytoplasmic sperm injection (ICSI), intubation, surfactant, antenatal steroids, intraventricular hemorrhage (IVH), amniotic infection syndrome, and persistent ductus arteriosus were studied as risk factors.

Results In this study, 344 preterm neonates were included, of whom 36 suffered from PH (10.5%). The mean time of the first occurrence was the third day of life (standard deviation [SD]: 1.2). On average, the patients suffered from 1.5 incidents (SD: 0.8) of PH, of whom 50% were severe. Preterm neonates born as multiples (95% confidence interval [CI]: 3.1, 26.9) and those who suffered from IVH (95% CI: 2.7, 18.9) had a significantly increased risk of PH. ICSI was not an independent risk factor.

Conclusion PH is significantly associated with IVH and multiple births but not with ICSI. The identification of patients at risk allows to apply prophylactic strategies of ventilation and pharmacological treatment.

Keywords

pulmonary hemorrhage - preterm - neonate - multiple births - intraventricular hemorrhage - intracytoplasmic sperm injection - in vitro fertilization
 

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