Hematological Parameters at Birth Fail to Predict Intraventricular Hemorrhage in Very Preterm Infants

Abstract

Objective - Recent studies have demonstrated associations between hematological parameters and indices (HPI) obtained from full blood count (FBC) collected on the first day of life (D1) and the occurrence of intraventricular hemorrhage (IVH) in premature infants. Our objective was to evaluate the association between HPI obtained from the FBC of D1 and the occurrence of IVH in premature infants, in order to assess whether these can be used as prognostic markers. Study Design - Retrospective study, at an academic tertiary center, including preterm infants with gestational age below 30 weeks. A statistical analysis compared two groups of infants, with and without IVH. Results - 206 infants were included, 86 (41.7%) in the IVH group and 120 (58.3%) in the no-IVH groups. The univariate analysis found that red blood cells (p=0.018), hemoglobin (p<0.001), and hematocrit (p=0.001) were significantly lower in the IVH group. The multivariate analysis by logistic regression adjusted to gestational age and birth weight revealed no significant associations between HPI of D1 and the occurrence of IVH. An analysis in the subgroup of patients with IVH-3 (severe IVH) also did not reveal an association between HPI and IVH-3. An association between bronchopulmonary dysplasia and IVH (all grades) was found (p=0.016). Also, periventricular infarction (p=0.002) and cystic periventricular leucomalacia (p < 0.001) were significantly more prevalent in the IVH-3 group. Conclusions - Our results demonstrate that HPI from FBC collected on D1 are not associated with the occurrence of IVH, and therefore cannot be used as predictors of IVH in extremely premature infants. Key words: blood count; hematological parameters; hematological indices; intraventricular hemorrhage; preterm infant