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Review
. 2014 Apr;3(2):76-88.
doi: 10.4103/2249-4847.134674.

A Systematic Review and Meta-analysis of the Timing of Early Intraventricular Hemorrhage in Preterm Neonates: Clinical and Research Implications

Sameer Yaseen Al-Abdi  1 , Maryam Ali Al-Aamri  2
Affiliations
Review

A Systematic Review and Meta-analysis of the Timing of Early Intraventricular Hemorrhage in Preterm Neonates: Clinical and Research Implications

Sameer Yaseen Al-Abdi et al. J Clin Neonatol. 2014 Apr.

Abstract

A considerable number of intraventricular hemorrhages (IVH) occur within the first hours of life (HOL). Temporality between IVH and its antecedents as well as a consistent definition of "early IVH" is lacking in a large and growing body of literature. We performed a systematic review of prospective studies that reported onset of IVH in preterm neonates within the first HOL and afterwards. The English literature was searched using three databases up to March 2013. Four timing periods of IVH can be compared in 16 identified studies: 0-6; 7-12; 13-24; after 24 HOL. The 0-6 and after 24 HOL were the major modes of IVH timing. Pooled IVH proportions were estimated through a meta-analysis of studies that were conducted after antenatal steroid and surfactant era. In neonates weighing ≤1500 g at birth: 48% of IVH (95% CI: 42-58%, 5 studies, 279 IVH cases) occurred during 0-6 HOL and 38% (95% CI: 19-57%, 4 studies, 241 IVH cases) after 24 HOL. The 0-6 HOL is the shortest, most vulnerable period for IVH, thus, an early IVH is an IVH occurs in it. Such early IVH had prognostic, etiological/preventive and medicolegal implications. Accordingly, preterm neonates at risk of IVH should have their first routine screening head ultrasound at about 6 HOL. Future research exploring the antecedents of IVH should guaranty the temporality between these antecedents and IVH. Additional research will be required to determine whether the long term neurological outcomes of early and late IVH are the same.

Keywords: Early intraventricular hemorrhage; head ultrasound; intraventricular hemorrhage; preterm neonates; timing of intraventricular hemorrhage; very low birth weight.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
The percent of intraventricular hemorrhage cases that occurred during different hours of life periods in low birth weight neonates
Figure 2
Figure 2
The percent of intraventricular hemorrhage cases that occurred during different hours of life periods in very low birth weight neonates
Figure 3
Figure 3
Forest plot of intraventricular hemorrhage proportion occurred during 0-6 h of life interval in very low birth weight neonates
Figure 4
Figure 4
Forest plot of intraventricular hemorrhage proportion occurred after 24 h of life interval in very low birth weight neonates
See this image and copyright information in PMC

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