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. 2025 May 19;15(1):17346.
doi: 10.1038/s41598-025-02061-4.

Risk assessment and early prediction of intraventricular hemorrhage in extremely preterm infants

Yueju Cai  1 , Xiaolan Li  2 , Xiaopeng Zhao  1 , Yanyan Song  2 , Wei Zhou  3
Affiliations

Risk assessment and early prediction of intraventricular hemorrhage in extremely preterm infants

Yueju Cai et al. Sci Rep. .

Abstract

This study aimed to identify the risk factors associated with intraventricular hemorrhage (IVH) in extremely preterm infants (EPIs), focusing on early-stage prediction to improve clinical outcomes. A retrospective cohort study was conducted at Guangzhou Women and Children's Medical Center, including 189 EPIs born between January 2019 and December 2023. Infants were categorized into IVH and non-IVH groups based on head ultrasound findings. Risk factors were assessed using univariate and multivariate analyses, and a predictive model for IVH was developed. Of the 189 EPIs, 80 (42.3%) developed IVH, with 26 (13.8%) experiencing severe IVH. Gestational age was identified as a significant protective factor (OR = 0.565, p = 0.023), while invasive mechanical ventilation (IMV) was a key risk factor (OR = 2.718, p = 0.012). The predictive model demonstrated good performance, with an AUC of 0.753 (95% CI: 0.681-0.825). Gestational age and IMV are critical factors in the development of IVH in EPIs. Early identification of high-risk infants based on these factors can aid in timely interventions to reduce IVH incidence and improve outcomes.

Keywords: Extreme preterm infants; Intraventricular hemorrhage; Neonatal care; Predictive model; Risk factors.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Women and Children’s Medical Center affiliated with Guangzhou Medical University (Approval No. 350B00) and conducted in accordance with relevant ethical guidelines. As this was a retrospective study, the requirement for informed consent was waived by the Ethics Committee of Women and Children’s Medical Center affiliated with Guangzhou Medical University in accordance with the Regulations for Ethical Review of Biomedical Research Involving Humans issued in China (No. 11, 2016). Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow of participation for extremely preterm infants.
Fig. 2
Fig. 2
Distribution of IVH, Severe IVH, and Post-Birth Incidence.
Fig. 3
Fig. 3
IVH and severe IVH by gestational age.
Fig. 4
Fig. 4
IVH and severe IVH by birth weight.
Fig. 5
Fig. 5
Forest plot of independent risk factors for IVH in EPIs.
Fig. 6
Fig. 6
ROC curve of the predictive model for IVH in EPIs.
See this image and copyright information in PMC

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