WIP 121 - Impact of trajectory of post-hemorrhagic ventricular dilatation on neurodevelopmental outcomes in preterm infants

Poster Number: WIP 121
Publication Number: WIP 121.2426

Background: Post-hemorrhagic ventricular dilatation (PHVD) in preterm infants can be progressive or resolve spontaneously over time. The implications of natural trajectory and influence of neurosurgical intervention on neurodevelopmental impairment (NDI) are not well characterized.

Objective: To assess in preterm infants the impact of PHVD trajectory on neurodevelopmental outcome at 21 months corrected age (CA).

Design/Methods: A retrospective cohort study of all preterm infants ( < 29 weeks’ gestation) born between 2010-2018 with any grade of intraventricular hemorrhage and ≥3 cranial ultrasounds (cUS) during throughout the neonatal period. PHVD was defined as anterior horn width >6mm and/or ventricular index >97th percentile for postmenstrual age. Infants were divided into three groups: no PHVD, PHVD without intervention and symptomatic PHVD requiring neurosurgical intervention. Group differences are being evaluated using Fisher’s exact or Pearson’s chi-squared test for categorical variables, analysis of variance for continuous variables where normality assumption was confirmed by Shapiro-Wilk’s test or Kruskal-Wallis test if normality assumption was not confirmed. A generalized linear model is being used to investigate neurodevelopmental outcomes at 21 months CA as assessed using the Bayley Scales of Infant Development 3rd Edition (BSID-III), the Gross Motor Functional Classification System (GMFCS) and validated hearing and vision tests, accounting for confounding variables for each group. Severe NDI is defined as ≥1 of BSID-III motor, cognitive or language composite score > 70, GMFCS 3 to 5, hearing aid or cochlear implant or bilateral visual impairment. Approval from the Conjoint Human Research Ethics Board at the University of Calgary was obtained (REB 20-1165); requirement for informed consent from participants for this study with anonymized data was waived. Data was extracted from clinical charts, neonatal-perinatal databases, and the electronic PACS system. Data collection is complete, analysis is ongoing and it is anticipated that this will be completed in November 2023.