Neonatal Med.  2014 Feb;21(1):18-27.

Risk Factor for Massive Pulmonary Hemorrhage Occurring during the First Five Days after Birth in Extremely Low Birth Weight Infants

• Kim SY
• Park JY
• Lee JA
• Choi CW
• Kim EK
• Kim HS
• Kim BI
• Choi JH

Abstract

PURPOSE
Massive pulmonary hemorrhage(MPH) within the first five days after birth is a major cause of early death in extremely low birth weight(ELBW) infants. The objective of this study was to determine risk factors for MPH in ELBW infants.
METHODS
Data were retrospectively collected from 115 ELBW infants admitted to Seoul National University Bundang Hospital between January 2007 and September 2012. MPH was defined as the presence of hemorrhagic fluid in the trachea accompanied by acute respiratory failure within the first five days after birth. Initial echocardiography and cranial ultrasonography were performed in all subjects before MPH. Clinical characteristics of ELBW infants with and without MPH were compared and the risk factors for MPH were investigated.
RESULTS
MPH occurred at 54+/-30 h after birth and was more frequent in ELBW infants with lower gestational age and lesser birth weight. Older maternal age was also associated with MPH. The presence of patent ductus arteriosus diagnosed using initial echocardiography was not significantly associated with MPH. The presence of intraventricular hemorrhage diagnosed using serial cranial ultrasonography was significantly associated with MPH. Logistic regression analysis indicated that among the variables that preceded MPH, only lower gestational age was independently associated with MPH.
CONCLUSION
Lower gestational age was found to be a risk factor for MPH within the first five days after birth in ELBW infants.

Keyword

Pulmonary hemorrhage; Extremely low birth weight infant; Risk factors

MeSH Terms

Birth Weight
Ductus Arteriosus, Patent
Echocardiography
Gestational Age
Hemorrhage*
Humans
Infant*
Infant, Extremely Low Birth Weight
Infant, Low Birth Weight*
Infant, Newborn
Logistic Models
Maternal Age
Parturition*
Respiratory Insufficiency
Retrospective Studies
Risk Factors*
Seoul
Trachea
Ultrasonography