Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study

Abstract Background This study aimed to explore the risk factors for early periventricular intraventricular hemorrhage (PIVH) in extremely low birth weight infants (ELBWIs), provide guidance for early intervention, and improve the survival rate and life expectancy of ELBWIs. Methods A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. The presence and severity of PIVH were assessed through standard head ultrasound screening (HUS) using the modified Papile classification on days 1–3 and 5–7 postbirth. The infants were categorized into either the PIVH group or the non-PIVH group based on the HUS findings. Univariate analysis and logistic regression were employed to identify the risk factors associated with PIVH. The efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve. Results Among the 205 ELBWIs (97 males and 108 females) included in the study, 82 patients (40.0%) developed PIVH, 26 patients (12.7%) had severe PIVH, and 56 patients (27.3%) had mild PIVH. Of the 82 PIVH cases, 51 occurred within 3 days after birth. The incidence rates of severe PIVH in the 23+ 1-26-, 26+ 1-28-, and 28+ 1-32-week gestational age groups were 40.0% (16/40), 10.7% (10/93), and 1.4% (1/72), respectively (χ2 = 34.392, p = 0.000). Logistic regression analysis revealed that failure to withdraw invasive ventilators within 1 week (OR = 3.668, 95% CI = 1.557–8.641, p = 0.003) and the use of vasoactive drugs within 1 week (OR = 2.193, 95% CI = 1.033–4.658, p = 0.041) were independent risk factors for PIVH (sensitivity = 68.3%).The specificity was 81.3%, and the AUC was 0.792. Conclusion The incidence of PIVH in extremely low birth weight infants is relatively high, particularly within the first three days after birth. The use of vasoactive drugs and delayed removal of invasive ventilators may increase the risk.