Intraventricular Hemorrhage in Premature Infants and Its Association with Pneumothorax

Intraventricular hemorrhage (IVH) is one of the major causes of the cerebral palsy and mental retardation. Prevention and early management of these neurologic developmental problems will require determining the perinatal risk factors associated with this clinical entity. Pneumothorax increase the risk of IVH, and cause of pneumothorax has an important effect in severity of IVH. This is a prospective cross sectional study in 2010. This study includes 150 preterm neonates. Cranial ultrasound was performed in all neonates in age 3, 7, 30, 60, just after pneumothorax and every 2 week until chest tube discontinuation. Then prevalence of IVH and pneumothorax was calculated in preterm infant and severity of IVH was investigated before and after development of pneumothorax, and this comparison was divided by different causes of pneumothorax with SPSS version 11.5. Prevalence of IVH and pneumothorax in preterm infants were 30% and 10% respectively. Pneumothorax was not a risk factor of IVH (P>0.05), but prevalence of pneumothorax caused by RDS was a risk factor of development of IVH (P=0.01). Also pneumothorax in patients with birth weight less than 1000 g and gestational age less than 28 week was a risk factor of IVH pneumothorax (P=0.008, P=0.01 respectively). Our study discusses the differences in previous studies about association of pneumothorax and IVH. Also we suggest the hypothesis that lack of cerebral autoregulation in neonates with gestational age less than 28 week can cause IVH development after hypotension induces by pneumothorax.