Respiratory Distress Syndrome: An Important Risk Factor for Intraventricular Hemorrhage in Preterm Neonates

Abstract

Introduction: Intraventricular hemorrhage (IVH) represents the most common pathology of the nervous system in neonates born before the 32nd week of gestation. Multiple factors present a risk for the development of IVH. It is important to know these factors for potential prevention and adequate treatment. Methodology: A retrospective clinical study was conducted at the Neonatal Intensive Care Unit of the Pediatric Clinic, Sarajevo University Clinical Center. Data were collected for 157 neonates in the period from 1 July 2023 to 31 December 2024. Results: Of the 157 premature neonates born at <32 weeks of gestation, 53 (33.8%) had IVH. We found that newborns with IVH had lower gestational age, birth weight, and Apgar scores, especially at the fifth minute. Contrary to many studies, the use of antenatal corticosteroids showed no protective effect. Newborns with respiratory distress syndrome (RDS) had a two-times higher relative risk for the development of IVH. Analysis showed a significant correlation between the duration of mechanical ventilation (MV) of more than three days and the incidence of IVH (24.1% vs. 54.5%; χ²=11.56; p<0.001), as well as between inotropic therapy and IVH (35.8% vs. 8.7%; χ²=17.72; p<0.001). In the group of children with a lethal outcome, 83.3% had IVH, compared with 16.7% who died without a diagnosis of IVH. Conclusion: RDS, lower gestational age, birth weight and Apgar score, MV longer than three days, and inotropic therapy were found to be important risk factors for the development of IVH in neonates born before the 32nd week of gestation.