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Obstetric Care and Intraventricular Hemorrhage in the Low Birth Weight Infant

From the Obstetric Division, Department of Obstetrics and Gynecology, and the Section of Newborn Services, Department of Pediatrics, The University of Michigan Medical School; and the Biostatistics Department, School of Public Health, University of Michigan, Ann Arbor, Michigan.

A concern of the obstetrician is whether any single event or combination of events before delivery places a prematurely born infant at increased risk of developing periventricular-intraventricular hemorrhage, a form of intracranial hemorrhage in 40 to 45% of all low birth weight infants. In this three-year retrospective study, 103 infants weighing less than 1500 g and delivering on or before the 35th gestational week showed evidence of intraventricular hemorrhage by routine cranial ultrasound scan. The finding of maternal hypertension, vaginal bleeding, or preterm ruptured membranes was similar in infants with intraventricular hemorrhage and a matched group of infants without hemorrhage. Premature labor, breech presentation, mode of delivery, and outborn birth also were not significantly different between the two groups. The finding of intraventricular hemorrhage in the low birth weight infant is related less to any one or combination of two prior obstetric events than to extreme prematurity and accompanying neonatal complications.