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. 2017 Sep;84(9):662-669.
doi: 10.1007/s12098-017-2319-z. Epub 2017 Apr 3.

Long-Term Neurodevelopmental and Growth Outcomes of Premature Infants Born at <29 week Gestational Age with Post-Hemorrhagic Hydrocephalus Treated with Ventriculo-Peritoneal Shunt

K Diwakar  1 , Walter J Hader  2   3   4   5 , A Soraisham  1   2   3   5 , Harish Amin  1   3   5 , Selphee Tang  5 , Kelly Bullivant  3   5 , Majeeda Kamaluddeen  1   3   5 , Abhay Lodha  6   7   8   9   10   11
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Long-Term Neurodevelopmental and Growth Outcomes of Premature Infants Born at <29 week Gestational Age with Post-Hemorrhagic Hydrocephalus Treated with Ventriculo-Peritoneal Shunt

K Diwakar et al. Indian J Pediatr. 2017 Sep.

Abstract

Objective: To compare long-term neurodevelopmental and growth (NDG) outcomes at 3 y corrected gestational age (GA) in premature infants with grade ≥ III intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus who were treated with ventriculo-peritoneal shunt with those who were not treated with shunt.

Methods: In a retrospective cohort study, NDG outcomes were compared between preterm infants of <29 wk GA with IVH treated with shunt (IVHS) and IVH with no shunt (IVHNS). This was a single centre study. The primary outcome was moderate to severe cerebral palsy (CP).

Results: Of 1762 preterm infants who survived to discharge, 90 had grade ≥ III IVH. Infants in IVHS group had more grade IV IVH than IVHNS (p < 0.05). Seventy percent of the patients in IVHNS groups had no hydrocephalus. IVHS group had increased CP (76% vs. 30%; p 0.003), and higher odds of CP after controlling for GA and IVH grade [odds ratio (OR); 4.23 (1.38 to 13.00)]. Growth delay was not different between groups.

Conclusions: Infants with IVHS are at increased risk of CP but not growth delay.

Keywords: Hydrocephalus; Intraventricular hemorrhage; Neurodevelopmental outcome; Preterm infants.

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