Analysis of Risk Factors for Intracranial Hemorrhage in Premature Infants of Different Gestational Ages

WANG Li

doi:10.14033/j.cnki.cfmr.2025.14.014

Abstract：Objective:To explore the risk factors of intracranial hemorrhage in preterm infants with different gestational ages.Method:The data of 1,100 preterm infants admitted to the Department of Neonatology,the First Affiliated Hospital of Guilin Medical University from January 2018 to December 2020 were retrospectively analyzed.Among them,91 cases had intracranial hemorrhage and 1,009 cases had no intracranial hemorrhage.According to the gestational age,228 cases had a gestational age of less than 32 weeks,and 872 cases had a gestational age of 32 to 36+6 weeks.The characteristics of intracranial hemorrhage at different gestational ages were analyzed,and the influencing factors were explored through univariate and multivariate analyses.Result:Among preterm infants with a gestational age of less than 32 weeks,there were statistically significant differences in the proportions of lactic acid(Lac)>4 mmol/L,use of pulmonary surfactant(PS),mechanical ventilation for more than 72 h,and intubation at birth between the intracranial hemorrhage group and the non-intracranial hemorrhage group(P<0.05).Further multivariate logistic regression analysis showed that Lac>4 mmol/L was an independent risk factor for intracranial hemorrhage in preterm infants with a gestational age of less than 32 weeks(OR=3.872,95%CI:1.438,10.425,P=0.007).Among preterm infants with a gestational age of 32 to 36+6 weeks,there were statistically significant differences in the proportions of Lac>4 mmol/L,respiratory distress syndrome(RDS),use of PS,mechanical ventilation for more than 72 h,premature rupture of membranes,and maternal gestational diabetes mellitus(GDM)between the intracranial hemorrhage group and the non-intracranial hemorrhage group(P<0.05).Further multivariate logistic regression analysis showed that premature rupture of membranes(OR=2.323,95%CI:1.350,3.997,P=0.002)and maternal GDM(OR=1.965,95%CI:1.084,3.560,P=0.026)were independent risk factors for intracranial hemorrhage in preterm infants with a gestational age of 32 to 36+6 weeks.Conclusion:Lac>4 mmol/L is an independent risk factor for intracranial hemorrhage in preterm infants with a gestational age of less than 32 weeks;premature rupture of membranes and maternal GDM are independent risk factors for intracranial hemorrhage in preterm infants with a gestational age of 32 to 36+6 weeks.