Analysis of risk factors of hydrocephalus after intraventricular hemorrhage in infants

Objective: Hydrocephalus following intraventricular hemorrhage is the most severe consequence of intraventricular hemorrhage (IVH) in babies. However, it is unclear what causes hydrocephalus. While the case series describes hydrocephalus linked to intraventricular bleeding, most investigations have limitations. The authors set out to examine the morphological and demographic aspects of hydrocephalus following intraventricular hemorrhage in a sizable cohort of infants in order to address this. Methods: The clinical information of 112 patients who were admitted to the Department of Neurosurgery, the third affiliated hospital of Zhengzhou University, between June 2013 and January 2022 was retrospectively evaluated. Sex, gestational age (in weeks), birth weight (in grams), grade of intraventricular hemorrhage, use of prenatal steroids, single or multiple births, mode of delivery (cesarean section), perinatal complications (history of hypoxia asphyxia), maternal complications (diabetes/hypertension), and other risk factors that may affect the formation of PHH were collected. Follow-up was done during the first 90 days postpartum. With real-time ultrasound,all the patients with progressive ventricular dilation that was not responsive to conservative or less-invasive procedures were considered to have PHH and were treated with a VP shunt. The patients were split into two groups based on the findings of the MRI test: those with PHH (n = 55) and those with RVD (n = 57), respectively. After an intraventricular hemorrhage, the risk variables for hydrocephalus were examined using univariate and multivariate logistic regression. Results: Overall, 55 of 112 patients had PHH (49%). By univariate comparison ,birth weight(p<0.001), gestational age(p<0.001), the grade of intraventricular hemorrhage(p<0.001) and the use of prenatal steroids(p<0.001) were associated with PHH. Multivariate analysis confirmed an independent effect of early preterm infants and prenatal steroids and bleeding grades. Conclusion: Early preterm infants are an independent risk factor for hydrocephalus. Without prenatal steroids, the higher the bleeding grade, the higher the risk of hydrocephalus.