Post-hemorrhagic ventricular dilatation and hydrocephalus in preterm infants: a five-year retrospective cohort study from a tertiary referral center.
4 affiliations
- 1Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- 2Pediatric Department, Shiraz University of Medical Sciences, Shiraz, Iran.
- 3MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- 4Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. [email protected].
Abstract
Background
Post-hemorrhagic hydrocephalus (PHH) is a serious complication of intraventricular hemorrhage (IVH) in preterm infants and is associated with increased morbidity and mortality. Although neonatal risk factors are well described, the contribution of maternal and perinatal factors remains inconsistent across studies.Objective
To determine the incidence, clinical characteristics, and independent predictors of PHH among preterm neonates with IVH, and to evaluate early outcomes in a tertiary referral center.Methods
This retrospective cohort study included preterm neonates (< 34 weeks' gestation or birth weight ≤ 1500 g) with ultrasound-confirmed IVH admitted to Namazi Hospital, Shiraz, Iran, between March 2019 and March 2024. Demographic, maternal, perinatal, and neonatal variables were extracted from medical records. PHH was defined as progressive ventricular dilatation following IVH. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of PHH.Results
Among 507 neonates with IVH, 154 (30.4%) developed PHH. Infants with PHH had significantly lower birth weight and gestational age and higher rates of maternal diabetes and neonatal meningitis.Each 100-g increase in birth weight was associated with a 24% reduction in the odds of developing post-hemorrhagic hydrocephalus (OR 0.76; 95% CI 0.7-0.83; p < 0.001).Maternal gestational diabetes mellitus/diabetes was a significant risk factor (OR 2.14; 95% CI 1.39-3.29; p = 0.001) Antenatal steroid exposure was associated with lower odds of PHH, possibly reflecting reduced hemorrhage severity(OR 0.53; 95% CI 0.35-0.80; p = 0.003).Mortality was borderline higher among infants with PHH (p = 0.05), while the need for surgical intervention was significantly higher in this group (p < 0.001).The primary clinical model demonstrated good calibration (Hosmer-Lemeshow p = 0.19) and acceptable discrimination (AUC = 0.75).Conclusion
PHH remains a frequent and severe complication of IVH in preterm neonates. Both neonatal and selected maternal factors contribute to PHH risk, underscoring the importance of comprehensive perinatal assessment and early identification of high-risk infants.
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BibTeX
@article{barzegar2026posthemorrhagic,
title = {{Post-hemorrhagic ventricular dilatation and hydrocephalus in preterm infants: a five-year retrospective cohort study from a tertiary referral center.}},
author = {Hamide Barzegar and Elham Khorasani and Hossein Molavi Vardanjani and Zahra Hashemi and Seyed Mostajab Razavinejad and Roya Oboodi},
journal = {BMC pediatrics},
year = {2026},
month = jul,
doi = {10.1186/s12887-026-07398-x},
url = {https://europepmc.org/article/MED/42907979},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Post-hemorrhagic ventricular dilatation and hydrocephalus in preterm infants: a five-year retrospective cohort study from a tertiary referral center.
AU - Hamide Barzegar
AU - Elham Khorasani
AU - Hossein Molavi Vardanjani
AU - Zahra Hashemi
AU - Seyed Mostajab Razavinejad
AU - Roya Oboodi
PY - 2026
DA - 2026/07/01
JO - BMC pediatrics
DO - 10.1186/s12887-026-07398-x
UR - https://europepmc.org/article/MED/42907979
AB - Background Post-hemorrhagic hydrocephalus (PHH) is a serious complication of intraventricular hemorrhage (IVH) in preterm infants and is associated with increased morbidity and mortality. Although neonatal risk factors are well described, the contribution of maternal and perinatal factors remains inconsistent across studies.Objective To determine the incidence, clinical characteristics, and independent predictors of PHH among preterm neonates with IVH, and to evaluate early outcomes in a tertiary referral center.Methods This retrospective cohort study included preterm neonates (< 34 weeks' gestation or birth weight ≤ 1500 g) with ultrasound-confirmed IVH admitted to Namazi Hospital, Shiraz, Iran, between March 2019 and March 2024. Demographic, maternal, perinatal, and neonatal variables were extracted from medical records. PHH was defined as progressive ventricular dilatation following IVH. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of PHH.Results Among 507 neonates with IVH, 154 (30.4%) developed PHH. Infants with PHH had significantly lower birth weight and gestational age and higher rates of maternal diabetes and neonatal meningitis.Each 100-g increase in birth weight was associated with a 24% reduction in the odds of developing post-hemorrhagic hydrocephalus (OR 0.76; 95% CI 0.7-0.83; p < 0.001).Maternal gestational diabetes mellitus/diabetes was a significant risk factor (OR 2.14; 95% CI 1.39-3.29; p = 0.001) Antenatal steroid exposure was associated with lower odds of PHH, possibly reflecting reduced hemorrhage severity(OR 0.53; 95% CI 0.35-0.80; p = 0.003).Mortality was borderline higher among infants with PHH (p = 0.05), while the need for surgical intervention was significantly higher in this group (p < 0.001).The primary clinical model demonstrated good calibration (Hosmer-Lemeshow p = 0.19) and acceptable discrimination (AUC = 0.75).Conclusion PHH remains a frequent and severe complication of IVH in preterm neonates. Both neonatal and selected maternal factors contribute to PHH risk, underscoring the importance of comprehensive perinatal assessment and early identification of high-risk infants.
SN - 1471-2431
ER -