Antenatal corticosteroid treatment for the prevention of peri-intraventricular haemorrhage in preterm newborns: a retrospective cohort study using transfontanelle ultrasonography

• Published in: Journal of ultrasonography Vol. 17; no. 69; pp. 91 - 95
• Main Authors: Almeida, Bianca A., Rios, Livia T., Júnior, Edward Araujo, Nardozza, Luciano M., Moron, Antonio F., Martins, Marília G.
• Format: Journal Article
• Language: English
• Published: Poland Sciendo 01.06.2017; Exeley Inc; Medical Communications Sp. z o.o
• Subjects: Analysis; Care and treatment; corticosteroid; Corticosteroid drugs; Dosage and administration; Health aspects; intraventricular haemorrhage; Intraventricular hemorrhage; Methods; Newborn infants; Original Paper; prematurity; Prenatal care; Prevention; transfontanelle ultrasonograph; transfontanelle ultrasonography; Ultrasound imaging; corticosteroid; transfontanelle ultrasonography; prematurity; intraventricular haemorrhage
• ISSN: 2084-8404; 2451-070X
• DOI: 10.15557/jou.2017.0012

The objective of this study was to assess the correlation between antenatal corticosteroids and peri-intraventricular haemorrhage (PIVH) using transfontanelle ultrasonography, as well as to evaluate the risk factors for its incidence. We performed a retrospective cohort study using medical records of preterm newborns. The protocol for maternal corticoid administration for foetal lung maturation included dexamethasone 4 mg (intramuscular) 8/8 hours per 48 hours, with one cycle per week. The diagnosis of periintraventricular haemorrhage was based on transfontanelle ultrasonography, using the Papile's classification. The following risk factors for peri-intraventricular haemorrhage were assessed: birth weight, gestational age at delivery, type of delivery, newborn's sex, surfactant administration, premature rupture of membranes and previous history of infection during the current pregnancy. The student's t-test and chi-square test were used for statistical analysis. Our sample population included 184 preterm newborns. Transfontanelle ultrasonography revealed peri-intraventricular haemorrhage in 32 (74.4%) and periventricular leukomalacia in 11 (25.6%) newborns. Grade I haemorrhage was found in 20 (62.5%), grade II in five (15.6%), and grade III in seven (21.8%) newborns, as in accordance with Papile's classification. Vaginal delivery ( = 0.010), birth weight <1500 g ( = 0.024), gestational age at delivery ≤32 weeks ( = 0.018), and previous history of infection during pregnancy ( = 0.013) were considered risk factors for peri-intraventricular haemorrhage in preterm newborns. Maternal corticoid administration for foetal lung maturation showed a protective effect against peri-intraventricular haemorrhage in preterm newborns. The risk factors for peri-intraventricular haemorrhage were determined.