1607 PROSPECTIVE LONG-TERM FOLLOW-UP OF PREMATURES WITH SUBEPENDYMAL/INTRAVENTRICULAR HEMORRHAGE (SEH/IVH)

Abstract

Since 1977, an ongoing study has assessed neurodevelopmental outcome of CT-documented SEH/IVH in infants <35 weeks gestation requiring intensive care. Scans were graded: normal, SEH, mild, moderate, or marked IVH. Follow-up status, at mean corrected age of 34 months, was assessed by neurologic exams, Bayley and Stanford-Binet tests. Outcome was designated: Good-no neurologic deficit and Developmental Index (D.I.) > 90. Intermediate-no or minor neurologic deficit and D.I. = 70-90: Poor-significant neurologic deficit or D.I.<70. The following groups were compared: a) 33/41 surviving SEH/IVH infants with 30/49 non-IVH; b)22 SEH/IVH infants paired with controls, matched for Apgar, gestation and birth weight c) intragroup, according to degree of hemorrhage. Of the 33 SEH/IVH infants, 21 had good outcomes, 8 intermediate, 4 poor. Of controls, outcome was good in 19, intermediate in 8, poor in 3. Among match-control pairs, there was a balanced distribution in outcome. Intragroup comparison showed: 13 had marked IVH with 8 good outcomes, 3 intermediate, 2 poor; 10 had moderate IVH with 5 good, 3 intermediate, 2 poor, 10 had mild IVH or SEH with 8 good, 2 intermediate, 0 poor. By all methods of comparison, outcome in SEH/IVH infants was not significantly different from controls. Marked IVH did not preclude good outcome (60% good). Other neonatal disease may affect outcome more than hemorrhage.

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