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2026, Number 1

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Arch Inv Mat Inf 2026; 17 (1)

Perinatal and postnatal factors determining germinal matrix-intraventricular hemorrhage in premature infants in a neonatal intensive care unit

Rodríguez-Balderrama I, Durón-Tábora I, Alanís-García PJ, Soto-Alonso IY, Rosales-Solís GM, Nieto-Sanjuanero A, Cárdenas-del Castillo BG

Language: Spanish
References: 25
Page: 15-22
PDF size: 674.33 Kb.


ABSTRACT

Introduction: germinal matrix-intraventricular hemorrhage (GMH-IV) is a lesion whose incidence and severity are inversely proportional to gestational age and weight. The objective of this study was to analyze which perinatal and postnatal factors contribute to the development of GMH-IV. Material and methods: this is an observational, comparative, retrospective case-control study. The records of premature neonates who presented GMH-IV from January 1, 2023, to December 31, 2024, were analyzed. The sample was divided into two groups for analytical comparison: the first group comprised premature neonates with intraventricular hemorrhage and the control group comprised newborns without hemorrhage. A univariate analysis was first performed, followed by binary logistic regression. Results: during the study period, there were 8,463 births, with 810 neonates admitted to the Neonatal Intensive Care Unit (NICU), of which 513 (63.4%) were premature, of which 202 were born between 24 and 33 weeks. In this latter age group, there were 34 patients with HMG-IV (with an incidence of 16.8%), and these were compared with 34 without hemorrhage. Statistical significance (p < 0.05) was observed for the group with hemorrhage in the weight range of 1,001-1,500 grams and with proven early sepsis. In infants without hemorrhage, mothers received more maturation inducers (51.5% vs 17.6% (p < 0.05). Conclusions: risk factors for HMG-IV were premature births weighing less than 1,500 grams and a diagnosis of proven early sepsis. The use of maturation inducers was a protective factor, with an 85.2% chance of avoiding intraventricular hemorrhage.


REFERENCES

  1. Riddle A, Miller SP, Back SA. Brain injury in the preterm infant. In: Gleason CA, Sawyer T, editors. Avery’s diseases of the newborn. 11th ed. Philadelphia: Elsevier; 2024. p. 809-814.

  2. Egesa WI, Odoch S, Odong RJ et al. Germinal matrix–intraventricular hemorrhage: a tale of preterm infants. Int J Pediatr. 2021; 2021: 6622598. doi: 10.1155/2021/6622598.

  3. Cizmeci MN, De Vries LS. Intracranial hemorrhage and stroke in the neonate. In: Martin RJ, Fanaroff AA, editors. Neonatal–perinatal medicine. 12th ed. Philadelphia: Elsevier; 2024. p. 1033-1058.

  4. Gomella TL, Eyal FG, Mohammed FB. Neonatology: management, procedures, on-call problems, diseases, and drugs. 8th ed. New York: McGraw Hill; 2020. p. 955-963.

  5. Lai GY, Shlobin N, Garcia RM et al. Global incidence proportion of intraventricular haemorrhage of prematurity: a meta-analysis of studies published 2010-2020. Arch Dis Child Fetal Neonatal Ed. 2022; 107 (5):513-519.

  6. Salas-Zazueta RR, Cabanillas-Ayón M, Canizales-Muñoz S. Características clínicas y epidemiológicasde hemorragia intraventricular en recién nacidosprematuros. Rev Med UAS. 2021; 11 (3): 198-209.

  7. Segura-Roldán MA, Rivera-Rueda MA, Fernández-Carrocera LA et al. Factores de riesgo asociados parael desarrollo de hemorragia intraventricular en reciénnacidos <1500 g ingresados a una UCIN. PerinatolReprod Hum. 2017; 31 (4): 174-179.

  8. Cervantes-Ruiz MA, Rivera-Rueda MA, Yescas-BuendíaG et al. Hemorragia intraventricular en recién nacidospretérmino en una Unidad de Tercer Nivel en la Ciudadde México. Perinatol Reprod Hum. 2012; 26 (1): 17-24.

  9. Barragán-Lee JR, Valenzuela-García L, Guerra-TamezA, Rodríguez-Balderrama I. Factores de riesgo dehemorragia intraventricular en prematuros menores de1500 g en el Hospital Universitario Dr. José EleuterioGonzález, UANL. Medicina Universitaria. 2005; 7: 116-122.

  10. Papile LA, Burstein J, Burstein R, Koffler H. Incidenceand evolution of subependymal and intraventricularhemorrhage: a study of infants with birth weights lessthan 1500 gm. J Pediatr. 1978; 92 (4): 529-534.

  11. Inder TE, De Vries LS, Ferriero DM et al. Neuroimagingof the preterm brain: review and recommendations. JPediatr. 2021; 237: 276-287.e4.

  12. Cizmeci MN, De Vries LS, Ly LG et al. Periventricularhemorrhagic infarction in very preterm infants:characteristic sonographic findings and associationwith neurodevelopmental outcome at age 2 years. JPediatr. 2020; 217: 79-85.e1.

  13. Parodi A, Govaert P, Horsch S, Bravo MA, Ramenghi LA.Cranial ultrasound findings in preterm germinal matrixhaemorrhage, sequelae and outcome. Pediatr Res.2020; 87: 13-24.

  14. Leijser LM, De Vries LS. Preterm brain injury: germinalmatrix intraventricular hemorrhage and posthemorrhagicventricular dilatation. Handb Clin Neurol.2019; 162: 173-199.

  15. Ramenghi LA, Fumagalli M, Groppo M et al. Germinalmatrix hemorrhage–intraventricular hemorrhage invery-low-birth-weight infants: the independent role ofinherited thrombophilia. Stroke. 2011; 42: 1889-1893.

  16. Zhou M, Wang S, Zhang T, Duan S, Wang H.Neurodevelopmental outcomes in preterm or low birthweight infants with germinal matrix–intraventricularhemorrhage: a meta-analysis. Pediatr Res. 2024; 95:625-633. doi: 10.1038/s41390-023-02877-8.

  17. McGoldrick E, Stewart F, Parker R, Dalziel SR. Antenatalcorticosteroids for accelerating fetal lung maturationfor women at risk of preterm birth. Cochrane DatabaseSyst Rev. 2020; 12: CD004454.

  18. De Luca D, Modi N, Davis P, Kasuda S, De Wildt SN,Kezler M et al. The Lancet Child & Adolescent HealthCommission on the future of neonatology. Lancet ChildAdolesc Health. 2025; 9: 578-612.

  19. Humberg A, Hartel C, Paul P et al. Delivery mode andintraventricular hemorrhage risk in very-low-birthweightinfants: observational data of the GermanNeonatal Network. Eur J Obstet Gynecol Reprod Biol.

  20. 2017; 212: 144-149.20. Wyckoff MH, Salhab WA, Heyne RJ et al. Outcomeof extremely low birth weight infants who receiveddelivery room cardiopulmonary resuscitation. J Pediatr.2012; 160 (2): 239-244.e2.

  21. Lee CH, Strand ML, Finan E, Illuzzi J, Kamath-RayneB, Kapadia V et al. Part 5: Neonatal resuscitation:2025 American Heart Association and AmericanAcademy of Pediatrics Guidelines for cardiopulmonaryresuscitation and emergency cardiovascular care.Circulation. 2025; 152 (Suppl 2): S385-S423. doi:10.1161/CIR.0000000000001367.

  22. Tarnow-Mordi W, Morris J, Kirby A et al. Delayed versusimmediate cord clamping in preterm infants. N Engl JMed. 2017; 377 (25): 2445-2455.

  23. Katheria A, Reister F, Essers J et al. Association ofumbilical cord milking vs delayed umbilical cordclamping with death or severe intraventricularhemorrhage among preterm infants. JAMA. 2019; 322(19): 1877-1886.

  24. Chock VY, Kwon SH, Ambalavanan N et al. Cerebraloxygenation and autoregulation in preterm infants(Early NIRS Study). J Pediatr. 2020; 227: 94-100.e1.

  25. Soul JS. Intracranial hemorrhage and white matterinjury/periventricular leukomalacia. In: EichenwaldEC, Hansen AR, Martin CR, Stark AR, editors. Manualof neonatal care. 9th ed. Philadelphia: Wolters Kluwer;2023. p. 796-824.




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