Intracranial haemorrhage in premature neonates - Epidemiology and prevention

Prematurity is the most important risk factor for intracranial haemorrhage (ICH). Many aetiological factors contribute to ICH in neonates, including t rauma with labour, mode of delivery, acidemia, hypoxia, hypercarbia, immatu rity of the coagulation system, change in newborn blood pressure, and newbo rn stress from resuscitation. Antenatal initiatives to prevent ICH have foc used on advancing gestational age, pharmacological interventions, optimisin g acid-base status and limiting intrapartum trauma. Neonatal initiatives ha ve focused on pharmacological and supportive measures which stabilise cereb ral blood now and oxygen delivery by local and systemic actions. The potent ial for pharmacological agents which could reduce capillary bleeding or act as antioxidiants to further prevent ICH remain a pressing research need.