Evaluation of risk factors, incidence, severity andprognosis of intraventricular hemorrhages in preterminfants followed in the Neonatal Intensive Care Unit ofCerrahpaşa Medical Faculty

EVALUATION OF RISK FACTORS, INCIDENCE, SEVERITY AND PROGNOSIS OF INTRAVENTRICULAR HEMORRHAGES IN PRETERM INFANTS FOLLOWED IN THE NEONATAL INTENSIVE CARE UNIT OF CERRAHPAŞA MEDICAL FACULTY ABSTRACT Objective: Intraventricular hemorrhage (IVH) is a major complication in preterm infants born before 32 weeks, often leading to serious neurological outcomes. The fragile vascular structure of the germinal matrix makes these infants more prone to cerebral bleeding. This study aimed to assess the incidence, severity, associated risk factors, and complications of IVH in preterm infants. Materials and Methods: This retrospective study included 156 preterm infants (≤32 weeks gestation) followed in the Neonatal Intensive Care Unit (NICU) at Istanbul University Cerrahpaşa Faculty of Medicine between January 2020 and December 2024. Infants with IVH diagnosed by cranial ultrasonography were compared to those without IVH. Clinical, laboratory, and radiological data were analyzed, focusing on IVH grades, risk factors, and related complications. Results: IVH was detected in 36.5% (n=57) of infants, distributed as 38.6% grade 1, 17.5% grade 2, 29.8% grade 3, and 14.0% grade 4. The IVH group had significantly lower gestational age and birth weight. Risk factors associated with IVH included multiple pregnancy, need for resuscitation, prolonged mechanical ventilation, early neonatal sepsis, and early transfusion. Hemodynamic instability, low mean arterial blood pressure, inotropic support, and blood pressure fluctuations were also linked to IVH. Severe IVH cases showed higher rates of complications such as ventricular dilatation, periventricular leukomalacia, cerebellar hemorrhage, and the need for surgical interventions. Conclusion: Low gestational age, low birth weight, hemodynamic fluctuations, sepsis, and early transfusion are prominent risk factors for IVH. Close hemodynamic monitoring, infection control, and cautious transfusion practices are essential for preventing IVH and improving outcomes. Keywords: Germinal matrix, Intraventricular hemorrhage, Prematurity