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EARLY DEVELOPMENTAL SEQUELAE OF INTRAVENTRICULAR HEMORRHAGE (IVH) IN PRETERM INFANTS

The effect of IVH on a preterm infant's development is unclear. The purpose of this study was to document developmental outcome of infants with IVH. From a cohort of 154 infants with BW<1750 g, we analyzed 62 survivors who had both ultrasound (US) and 12 mos. developmental (dev) data and 24 children with US data who expired. 59 children missing either US or dev. data were omitted. US were graded from 0-4. Bayley scales were used to assess development. Overall, there were major mental delays (MDI<69) in 5%, minor delays (MDI<85) in 11% and normal devel. in 84%. There were major motor delays (PDI < 69) in 16%, minor delays (PDI < 85) in 19% and normal devel. in 65%. Infants were grouped according to their worst grade of IVH. 100% of those with major mental delays had greater than Gr 2 IVH. Of the children with minor mental delays, 29% had Gr I, 57% had Gr 3, & 14% had Gr 4. Of those with major motor delays 40% had Gr 0, 10% Gr 2, 40% Gr 3 & 10% Gr 4. Of those with minor motor delays, 25% were Gr 0, 17% Gr 1, 8% Gr 2, 25% Gr 3 & 25% Gr 4. The table demonstrates the mean developmental scores for each IVH grade.Conclusions:1) Children with grade 1 & 2 IVH do not differ in dev. from children with Gr 0. 2) Though children with 3 & 4 IVH account for a higher percentage of delays, such bleeds do not preclude normal development. 3) IVH status alone is not an accurate predictor of developmental outcome.