The Analysis Of Related Factors Of Neonatal Intracranial Hemorrhage

Objective:Intracranial hemorrhage(ICH)is a common disease among newborns.Intracranial hemorrhage is a severe disease which obstetrics and neonatologist need to face together.The lower the gestational age or birth weight,the higher the incidence of intracranial hemorrhage and the more severe the severity.For premature infants with severe intracranial hemorrhage,the mortality rate is even up to27% ～ 50%.Severe intracranial hemorrhage can lead to different degree of nervous system sequelae,such as epilepsy,cerebral palsy,sensorimotor disorders,and cognitivel and behaviora impairment,which bring a serious burden to the families and the society.By analyzing the related risk factors of neonatal intracranial hemorrhage,the independent risk factors of neonatal intracranial hemorrhage were identified to improve the understanding of this disease,we can enable the maternal,neonatologist and obstetrician to precisely take the corresponding measures to intervene against these factors,so as to prevent the occurrence of neonatal intracranial hemorrhage.Methods:The study group consisted of 112 neonates who were admitted to our department of neonatology and had intracranial hemorrhage confirmed by brain ultrasound from January 2016 to June 2019.While the control group comprised of 112 neonates who had no intracranial hemorrhage confirmed by brain ultrasound、CT or MRI during the same period。All the data were analyzed by SPSS statistical software.Measure data were expressed as mean±standard deviation.T test was used to compare the differences between groups.The categorical variable was statistically described by the number of people(percentage),and the chi-square test was used to compare the differences between groups.When the number of cells in the chi-square test was < 5,the fisher accurate test was used to analyze the differences between groups.Logistic regression analysis was carried out to analyze the independent effect of the difference between the two groups.Results:1.Analysis of maternal related factors: The proportion of single child in the study group was higher(P=0.040),and the difference was statistically significant.Compared with the control group,the proportion of prenatal hormone use was higher in the study group(P=0.008),and the difference was statistically significant.There were no statistically significant differences between the two groups in maternal age,birth order,gestational hypertension,gestational diabetes mellitus,premature rupture of membranes,and whether or not to preserve the fetus(P>0.05).2.Analysis of parturition-related factors: Compared with the control group,the ratio of natural birth was higher in the study group(P=0.023).There were no statistically significant differences between the two groups in intrauterine distress,placental abnormality,umbilical cord around neck,fetal malposition,amniotic fluid turbidity and bloody amniotic fluid(P>0.05).In the study group,the number(percentage)of birth asphyxia was 21(18.8%),higher than the control group,and the difference was statistically significant(P<0.001).3.Analysis of neonatal related factors: There was no significant statistical difference between the control group and the study group(P=0.893).The mean gestational age of newborns in the control group and the study group was 36.1 weeks and 34.2 weeks,respectively,and the difference was statistically significant(P<0.001).The mean weight of newborns in the control group and the study group was 2533 g and 2137 g,respectively,and the difference was statistically significant(P<0.001).The number(percentage)of mechanical ventilation,non-invasive respiratory support,low platelet count and metabolic acidosis in the study group were all higher than those in the control group,and the differences were statistically significant(P<0.05).The coagulation function of the control group and study group was not included in the statistical analysis due to the lack of data.4.Single factor analysis showed that there were differences in gestational age,birth weight,asphyxia,metabolic acidosis,thrombocytopenia,noninvasive respiratory support and mechanical ventilation between the two groups(P < 0.05).5.Multiple regression analysis showed that birth weight < 1500 g and asphyxia were the independent risk factors of neonatal intracranial hemorrhage(P < 0.05).Conclusion:1.Birth weight <1500g and postpartum asphyxia and are independent risk factors for intracranial hemorrhage.Fetal age,mechanical ventilation,low platelet count,and metabolic acidosis were associated risk factors for ICH in neonates,and cesarean section was considered as a protective factor for ICH in neonates.2.Avoiding premature delivery,low birth weight and birth asphyxia,avoiding improper mechanical ventilation,active monitoring of platelets,and corresponding treatment can effectively prevent the occurrence of neonatal ICH.