Table 3.
Potential risk factors in term asphyxiated newborns treated with hypothermia and developing intraventricular hemorrhage
| General population of term asphyxiated newborns treated with hypothermia (n = 145) | Term asphyxiated newborns treated with hypothermia and developing IVH (n = 15) | p value | IVH limited to the choroid plexus vessels in the lateral ventricles or IVH without ventricular dilatation (n = 8) | IVH without ventricular dilatation or parenchymal hemorrhage (n = 7) | p value | |
|---|---|---|---|---|---|---|
| Risk factors | ||||||
| Asphyxia | ||||||
| Hypoxic-ischemic encephalopathy, n (%) | 145 (100) | 15 (100) | - | 8 (100) | 7 (100) | - |
| Brain hypoxic-ischemic injury, n (%) | 67 (46) | 5 (38) | NS | 3 (38) | 3 (60a) | NS |
| Treatment | ||||||
| Hypothermia/rewarming, n (%) | 145 (100) | 15 (100) | - | 8 (100) | 7 (100) | − |
| Hemodynamic instability | ||||||
| Mechanical ventilation, n (%) | 98 (68) | 10 (67) | NS | 4 (50) | 5(71) | NS |
| Lowest pCO2 level | 29.2 ± 8.78 | 28.7 ± 4.2 | NS | 30.1 ± 3.4 | 26.8 ± 4.8 | NS |
| Highest pCO2 level | 55.4 ± 15.6 | 57.1 ± 12.7 | NS | 55.7 ± 13.4 | 59.0 ± 12.6 | NS |
| Highest pCO2variations | 27.0 ± 15.6 | 28.4 ± 15.1 | NS | 25.6 ± 15.6 | 32.2 ± 14.8 | NS |
| Duration of mechanical ventilation, days | 3.3 ± 5.0 | 3.5 ± 4.1 | NS | 1.4 ± 1.9 | 5.8 ± 4.8 | NS |
| Persistent pulmonary hypertension, n (%) | 46 (32) | 6 (40) | NS | 2(25) | 4(57) | NS |
| Hypotension, n (%) | 81 (56) | 10 (67) | NS | 5 (63) | 5(71) | NS |
| Hemostasis disturbances | ||||||
| Thrombocytopenia, n (%) | 34 (23) | 7(47) | NS | 2(25) | 5(71) | NS |
| Coagulopathy, n (%) | 46 (32) | 11 (73) | 0.004 | 7(88) | 4(57) | NS |
| Metabolic disturbances | ||||||
| Hypoglycemia, n (%) | 16 (11) | 3 (20) | NS | 1 (13) | 2 (29) | NS |
| Other | ||||||
| Venous sinus thrombosis, n (%) | 3(2) | 0(0) | NS | 0(0) | 0(0) | - |
| Traumatic birth/instrumental delivery, n (%) | 34 (23) | 5 (33) | NS | 2(25) | 3(43) | NS |
aTwo patients did not have a brain MRI or an autopsy to define the extent of brain surgery.
Abbreviations: IVH intraventricular hemorrhage, NS non-significant