Abstract
Background Advancements in neonatal care have increased preterm infant survival but paradoxically raised intraventricular hemorrhage(IVH)rates.This study explores IVH prevalence and long-term outcomes of very low birth weight(VLBW)infants in Korea over a decade.Methods Using Korean National Health Insurance data(NHIS,2010-2019),we identified 3372 VLBW infants with IVH among 4,129,808 live births.Health-related claims data,encompassing diagnostic codes,diagnostic test costs,and adminis-tered procedures were sourced from the NHIS database.The results of the developmental assessments are categorized into four groups based on standard deviation(SD)scores.Neonatal characteristics and complications were compared among the groups.Logistic regression models were employed to identify significant changes in the incidence of complications and to calculate odds ratios with corresponding 95％confidence intervals for each risk factor associated with mortality and morbid-ity in IVH.Long-term growth and development were compared between the two groups(years 2010-2013 and 2014-2017).Results IVH prevalence was 12％in VLBW and 16％in extremely low birth weight(ELBW)infants.Over the past decade,IVH rates increased significantly in ELBW infants(P=0.0113),while mortality decreased(P=0.0225).Major improve-ments in certain neurodevelopmental outcomes and reductions in early morbidities have been observed among VLBW infants with IVH.Ten percent of the population received surgical treatments such as external ventricular drainage(EVD)or a ven-triculoperitoneal(VP)shunt,with the choice of treatment methods remaining consistent over time.The IVH with surgical intervention group exhibited higher incidences of delayed development,cerebral palsy,seizure disorder,and growth failure(height,weight,and head circumference)up to 72 months of age(P＜0.0001).Surgical treatments were also significantly associated with abnormal developmental screening test results.Conclusions The neurodevelopmental outcomes of infants with IVH,especially those subjected to surgical treatments,continue to be a matter of concern.It is imperative to prioritize specialized care for patients receiving surgical treatments and closely monitor their growth and development after discharge to improve developmental prognosis.
基金项目
Korea Medical Device Development Fund grant funded by the Korea government the Ministry of Science and ICT()
Ministry of Trade,Industry and Energy()
Ministry of Health & Welfare,the Ministry of Food and Drug Safety(1711138055)
Ministry of Health & Welfare,the Ministry of Food and Drug Safety(KMMDF_PR_20200901_0057)
NETL
NSTL
万方数据