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. 2025 Jul 31;20(7):e0328406.
doi: 10.1371/journal.pone.0328406. eCollection 2025.

Incidence of intraventricular haemorrhage, associated risk factors and short-term outcomes among preterm neonates in a tertiary referral hospital in Kenya

Annette Baine Mwatha  1 , Roseline Ochieng  1 , Rosebella Iseme-Ondiek  2
Affiliations

Incidence of intraventricular haemorrhage, associated risk factors and short-term outcomes among preterm neonates in a tertiary referral hospital in Kenya

Annette Baine Mwatha et al. PLoS One. .

Abstract

Background: Intraventricular hemorrhage (IVH) stands as the predominant cause of brain injury with the incidence increasing with the decrease in birth weight and gestational age. In developed countries, a reduction in IVH incidence by implementing small baby neuroprotective protocols has been reported. The incidence of IVH within our setting is largely unexplored. This study aimed to fill this gap by determining the incidence and associated risk factors of IVH to guide in implementing a small baby neuroprotective protocol that could potentially reduce the incidence of IVH.

Method: A retrospective cohort study from January 2020 to December 2023 included all Preterm babies with gestation age < 32 weeks or birthweights of ≤1500g admitted to the neonatal intensive care unit (NICU) at The Aga Khan University Hospital, Nairobi. The primary outcome was the occurrence of IVH, while secondary outcomes were associated risk factors and short-term outcomes of IVH.

Results: A total of 526 babies were admitted to the NICU during the study period. Of these, 135 preterm infants were recruited, and 45 (33.3%) developed IVH, predominantly grade 1 IVH, which occurred predominantly between days 0-28 of life. Logistic regression analysis identified that exposure to antenatal steroids exhibited significantly lower odds of IVH occurrence (AOR 0.075, 95% CI 0.007-0.757). Resuscitation in the NICU had a 3 times higher risk of developing IVH (AOR 2.773, 95% CI 0.867-8.874). Treatment with normal saline bolus and inotropes had 4 times higher odds of IVH occurrence (OR 3.5, 95% CI: 1.043-11.885). A higher mortality rate was observed in preterms with IVH (26.6% vs 13.3%). Post-hemorrhagic ventricular dilation (22% vs 6.7%) and periventricular leukomalacia (20% vs 6.7%) were significantly higher among preterms with IVH.

Conclusion: The findings elicited from this study lay a foundation for the implementation of neuroprotective protocols which may potentially reduce the magnitude of IVH in this highly vulnerable age group.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the recruitment process, imaging done, and day 28 outcome.
The flow diagram outlines the participant recruitment process, the number of babies scanned (n = 135) and the clinical outcomes assessed at day 28. It also includes the number of excluded study participants and reasons for their exclusion, the number of cranial ultrasounds performed and the outcomes grouped by survival.
Fig 2
Fig 2. Timing of IVH by grade severity over 28 days of life.
See this image and copyright information in PMC

References

    1. Irimu G, Aluvaala J, Malla L, Omoke S, Ogero M, Mbevi G. Neonatal mortality in Kenyan hospitals: a multisite, retrospective cohort study. BMJ Glob Health. 2021;6(5):e004810. - PMC - PubMed
    1. Kenya National Bureau of Statistics (KNBS), Ministry of Health (Kenya), National AIDS Control Council (NACC), Kenya Medical Research Institute (KEMRI), National Council for Population and Development (NCPD), ICF. Kenya Demographic and Health Survey 2022. Nairobi, Kenya: KNBS. 2023.
    1. World Health Organization, Regional Office for the Western Pacific. Sustainable development goals (SDGs): Goal 3. Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age. Manila: WHO Regional Office for the Western Pacific. 2016.
    1. World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes. Geneva: World Health Organization. 2015. - PubMed
    1. Siffel C, Kistler KD, Sarda SP. Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review. J Perinat Med. 2021;49(9):1017–26. doi: 10.1515/jpm-2020-0331 - DOI - PubMed