Early predictors of neonatal intraventricular hemorrhage
Keywords:
Neonate, Hemorrhage, PredictorsAbstract
Objective: Current study aimed toward the early prediction of neonatal intraventricular hemorrhage (IVH) for better management and prognosis.
Methods: This prospective study was conducted on forty neonates at the Neonatal Intensive Care Unit of Pediatrics and Medical Biochemistry department (Tanta University, Egypt) from July 2016 to June 2017. Cord blood erythropoietin and venous blood Activin A were assayed within the first hour of life. Neonates were divided into 2 groups: Group 1 (with IVH) included twenty neonates who developed IVH proved by transcranial ultrasonography (u/s) and Group 2 (without IVH) included twenty neonates who were admitted to the NICU but did not develop IVH, also proved by transcranial u/s. Data were analyzed using Chi Square and t-test.
Results: Group 1 had a significantly higher cord blood erythropoietin concentration than group 2 (46.75±27.98 mIU/mL vs. 18.82±8.91 mIU/mL), respectively (p<0.05). Group 1 had a significantly higher venous blood Activin A concentration than group 2 (3.18±2 ng/L vs. 0.42±0.25 ng/L) with (p<0.05).
Conclusion: Cord blood erythropoietin and venous blood Activin A were presumed to be used as early predictors of IVH in neonates with early treatment and better prognosis
References
McCrea HJ, Ment LR. The diagnosis, management, and postnatal prevention of intraventricular
hemorrhage in the preterm neonate. Clin Perinatol. 2008; 35(4): 777-92. doi: 10.1016/j.clp.2008.07.014.
PMID: 19026340, PMCID: PMC2901530.
Ballabh P. Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatr Res. 2010;
:1–8. doi: 10.1203/PDR.0b013e3181c1b176. PMID: 19816235, PMCID: PMC2799187.
Sarkar S, Bhagat I, Dechert R, Schumacher RE, Donn SM. Severe intraventricular hemorrhage in preterm
infants: comparison of risk factors and short-term neonatal morbidities between grade 3 and grade 4
intraventricular hemorrhage. Am J Perinatol. 2009; 26: 419–24. doi: 10.1055/s-0029-1214237.
Antoniuk S, da Silva RV. Periventricular And Intraventricular hemorrhage in the premature infants. Rev
Neurol. 2000; 31: 238–43. PMID: 10996925.
McAdams RM, McPherson RJ, Mayock DE, Juul SE. Outcomes of extremely low birth weight infants
given early high dose erythropoietin. J Perinatol. 2013; 33: 226-31. doi: 10.1038/jp.2012.78. PMID:
, PMCID: PMC4029129.
Fan X, Heijnen CJ, van der Kooij MA, Groenendaal F, van Bel F. The role and regulation of hypoxiainducible factor-1alpha expression in brain development and neonatal hypoxic-ischemic brain injury. Brain
Res Rev. 2009; 62: 99–108. doi: 10.1016/j.brainresrev.2009.09.006. PMID: 19786048.
Florio P, Gazzolo D, Luisi S, Petraglia F. Activin A in brain injury. Adv Clin Chem. 2007; 43: 117–30. doi:
1016/s0065-2423(06)43004-3. PMID: 17249382.
Florio P, Perrone S, Luisi S, Vezzosi P, Longini M, Marzocchi B. Increased plasma concentrations of
activin a predict intraventricular hemorrhage in preterm newborns. Clin Chem. 2006; 52: 1516–21. doi:
1373/clinchem.2005.065979. PMID: 16740650.
Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to
include extremely premature infants. J Pediatrics. 1991; 119: 417-23. doi: 10.1016/S0022-3476(05)82056- 6.
Volpe JJ. Intracranial hemorrhage: Germinal matrix-intraventricular hemorrhage. In: Neurology of the
Newborn, 5th ed, Philadelphia: Saunders; 2008: 517-88.
Wide L, Bengtsson C, Birgegård G. Circadian Rhythm of Erythropoietin in Human Serum. Br J Haematol.
; 72: 85-90. doi: 10.1111/j.1365-2141.1989.tb07657.x. PMID: 2736245.
Cahan C, Decker MJ, Arnold JL, Washington LH, Veldhuis JD, Goldwasser E, et al. Diurnal variations in
serum erythropoietin levels in healthy subjects and sleep apnea patients. J Appl Physiol. 1992; 72: 2112-7.
PMID: 1629063.
Goldwasser E, Sherwood JB. Annotation, Radioimmunoassay of Erythropoietin. Br J Haematol. 1981; 48:
-63. doi: 10.1111/j.1365-2141.1981.tb02726.x.
Jain NJ, Kruse LK, Demissie K, Khandelwal M. Impact of mode of delivery on neonatal complications:
trends between 1997 and 2005. J Matern Fetal Neonatal Med. 2009; 22(6): 491-500. doi:
1080/14767050902769982.
Aher SM, Ohlsson A. Late erythropoietin for preventing red blood cell transfusion in preterm and/or low
birth weight infants. Cochrane Database Syst Rev. 2012; 9: 868. doi: 10.1002/14651858.CD004868.pub4.
PMID: 24760628.
Riskin A, Riskin Mashiah S, Bader D, Kugelman A, Lerner-Geva L, Boyko V, et al. Delivery mode and
severe intraventricular hemorrhage in single, very low birth weight, vertex infants. Obstet Gynecol. 2008;
: 21-8. doi: 10.1097/AOG.0b013e31817cfdf1. PMID: 18591303.
Badiee Z. Intraventricular hemorrhage in very low birth weight infants. Associated risk factors in Isfahan,
Iran. Saudi Med J. 2007; 28: 1362-6. PMID: 17768461.
Vural M, Yilmaz I, Ilikkan B, Erginoz E, Perk Y. Intraventricular hemorrhage in preterm newborns: risk
factors and results from a University Hospital in Istanbul, 8 years after. Pediatr Int. 2007; 49(3): 341-4. doi:
1111/j.1442-200X.2007.02381.x. PMID: 17532832.
Kim KR, Jung SW, Kim DW. Risk factors associated with germinal matrix-intraventricular hemorrhage in
preterm neonates. J Korean Neurosurg Soc. 2014; 56: 334-7. doi: 10.3340/jkns.2014.56.4.334. PMID:
, PMCID: PMC4219192.
Bhandari V, Buhimschi CS, Han CS, Lee SY, Pettker CM, Campbell KH, et al. Cord blood erythropoietin
and interleukin-6 for prediction of IVH in the preterm neonate. J Matern Fetal Neonatal Med. 2011; 24:
-9. doi: 10.3109/14767058.2010.520048. PMID: 20937006, PMCID: PMC3683649.
Korzeniewski SJ, Allred E, Logan JW, Fichorova RN, Engelke S, Kuban KC, et al. Elevated endogenous
erythropoietin concentrations are associated with increased risk of brain damage in extremely preterm
neonates. PLoS One. 2015; 10: e0115083. doi: 10.1371/journal.pone.0115083. PMID: 25793991, PMCID:
PMC4368546.
Elmahdy H, El-Mashad AR, El-Bahrawy H, El-Gohary T, El-Barbary A, Aly H. Human recombinant
erythropoietin in asphyxia neonatorum: pilot trial. Pediatrics. 2010; 125(5): e1135-42. doi:
1542/peds.2009-2268. PMID: 20385632.
Florio P, Luisi S, Moataza B, Torricelli M, Iman I, Hala M, et al. High urinary concentrations of activin A
in asphyxiated full-term newborns with moderate or severe hypoxic ischemic encephalopathy. Clin Chem.
; 53: 520-2. doi: 10.1373/clinchem.2005.062604. PMID: 17259240.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.