Am J Perinatol 1984; 1(4): 325-330
DOI: 10.1055/s-2007-1000032
ORIGINAL ARTICLE

© 1984 by Thieme Medical Publishers, Inc.

Intracranial Hemorrhage and Neurodevelopmental Outcome at One Year in Infants Weighing 1200 Grams or Less

Prognostic Significance of Ventriculomegaly at Term Gestational AgeMary Ellen Bozynski1 , Michael N. Nelson2 , Diane Genaze3 , Celine Rosati-Skertich3 , Wayne S. Chilcote, Jr.4 , Ruth G. Ramsey4 , Karen J. O'Donnell5 , Werner A. Meier6
  • 1Department of Pediatrics, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
  • 2Departments of Pediatrics and Psychology, Rush-Presbyterian-St. Luke's Medical Center, and the Institute for the Study of Developmental Disabilities, Chicago, Illinois
  • 3Department of Physical Therapy, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
  • 4Department of Radiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
  • 5Wake County Medical Center, Raleigh, North Carolina
  • 6Departments of Pediatrics and Obstetrics and Gynecology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
Further Information

Publication History

Publication Date:
04 March 2008 (online)

ABSTRACT

Seventy-five surviving infants weighting 1200 g or less at birth were followed up longitudinally, employing real-time ultrasonographic examination of the brain from birth to term corrected gestational age. Evaluations using the Milani-Comparetti Motor Developmental Screening Test and developmental testing using the Bayley Scales of Infant Development were performed at 4, 8, and 12 months corrected age. Thirty-five (46.7%) of the infants were diagnosed to have intracranial hemorrhage (ICH). These infants were significantly smaller and lighter and were mechanically ventilated close to five times longer than infants without ICH. ICH was predictive of poorer developmental outcome through the first postnatal year. ICH infants had significantly lower Bayley motor scores at both 4 and 12 months. Sixteen of the 20 who scored less than 84 on one or both of the Bayley Scales at one year had a history of ICH. When infants with hemorrhage and normal ventricles at term (ICH-no VM) were compared to infants with hemorrhage and ventriculomegaly at term (ICH-VM), the poorest motor outcome was seen in the ICH-VM group. Only the ICH-VM group showed motor performance significantly poorer than the non-ICH group at 12 months of age. Regardless of severity of hemorrhage, the data suggested an added risk for poorer developmental outcome in ICH survivors who had ventriculomegaly or abnormal periventricular morphology at term. Thus, intracranial hemorrhage per se indicates significantly greater risk of short-term motor sequelae continuing through the first four postnatal months, but persistently abnormal ventricles serve as a more significant “marker” of risk for longer term neuromotor delays at one year corrected age. Recovery of normal ventricular morphology by term gestational age apparently indexes recovery from ICH and predicts a more normal developmental outcome by the end of the first postnatal year.