Perinatal factors associated with severe intracranial hemorrhage

OBJECTIVE: The purpose of this study was to assess the incidence of perinat al factors that are associated with severe intracranial hemorrhage in a lar ge and recent multicenter experience. STUDY DESIGN: Retrospective analyses of nonanomalous newborns who were admi tted to 100 neonatal intensive care units from 23 to 34 (6)/(7) weeks' gest ation were analyzed by multiple regression. RESULTS: There were 12,578 premature newborns with a mean ( +/- SD) gestati onal age of 31.3 +/- 2.9 weeks and a birth weight of 1685 +/- 571 g, respec tively. The overall incidence of severe intracranial hemorrhage was 2.9%; i n 4575 newborns who weighed less than or equal to 1500 g the incidences of intracranial hemorrhage was 7.1%. Factors with positive and negative associ ations with severe intracranial hemorrhage are listed in order of decreasin g statistical significance: gestational age (negative), surfactant (positiv e), antenatal indomethacin (positive), neonatal transport (positive), cesar ean birth (negative), poor prenatal care (positive), 5-minute Apgar score o f <7 (positive), chorioamnionitis (positive), antenatal terbutaline (negati ve), preterm premature rupture of fetal membranes (negative), and abruption (positive). CONCLUSION: The incidence of severe intracranial hemorrhage has dramaticall y declined over the past 2 decades. Antenatal steroids were not associated with reductions in severe intracranial hemorrhage.