Germinal Matrix Hemorrhage: Intraventricular Hemorrhage in Very-Low-Birth-Weight Infants

医学 脑室出血 生发基质 低出生体重 脑出血 脑出血 麻醉 内科学 怀孕 胎龄 蛛网膜下腔出血 血压 遗传学 生物
作者
Luca A. Ramenghi,Monica Fumagalli,Michela Groppo,Dario Consonni,Loredana Gatti,Pier Alberto Bertazzi,Pier Mannuccio Mannucci,Fabio Mosca
出处
期刊:Stroke [Lippincott Williams & Wilkins]
卷期号:42 (7): 1889-1893 被引量:62
标识
DOI:10.1161/strokeaha.110.590455
摘要

Background and Purpose— The etiology of germinal matrix hemorrhage–intraventricular hemorrhage (GMH-IVH) is multifactorial and the role of genetic polymorphisms is unclear. The aim of this prospective study was to evaluate prothrombotic genetic mutations as independent risk factors for the development of all grades of GMH-IVH in very-low-birth-weight infants. Methods— The presence of both factor V Leiden and prothrombin gain-of-function gene mutations were prospectively assessed in 106 very-low-birth-weight infants. Infants with GMH-IVH were compared to those without GMH-IVH according to genetic and clinical characteristics. Results— Twenty-two out of 106 infants had GMH-IVH develop (20.7%). Infants with GMH-IVH had significantly lower gestational ages and birth weights. In the multivariate Poisson regression model, the prevalence of GMH-IVH appeared to be inversely related to gestational age, with a risk ratio of 0.83 (95% CI, 0.72–0.97; P =0.02) per week. Risk ratio of GMH-IVH for carriers of either prothrombotic mutation was 2.65 (95% CI, 1.23–5.72; P =0.01), similar to the risk ratio associated with need for resuscitation at birth (2.30; 95% CI, 1.02–5.18; P =0.04). Conclusions— Very-low-birth-weight infants who are carriers for either prothrombotic mutations are at increased risk for development of GMH-IVH. Genetic factors act as independent risk factors of the same magnitude as other known risk factors.
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