Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants

Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants

Author Testoni, Daniela Google Scholar
Hornik, Christoph P. Google Scholar
Guinsburg, Ruth Google Scholar
Clark, Reese H. Google Scholar
Greenberg, Rachel G. Google Scholar
Benjamin, Daniel K., Jr. Google Scholar
Smith, P. Brian Google Scholar
Abstract Background: Lumbar puncture (LP) is the gold standard for diagnosing meningitis

however it is unknown whether early LP (<= 3 days of life) is associated with increased risk of intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants. Objective: To determine whether early LP in VLBW infants is associated with severe IVH. Methods: VLBW infants from a cohort of 1,158,789 infants discharged from 382 neonatal intensive care units (1997-2015) were enrolled. Exclusion criteria: infants with major congenital anomalies, outborns, died/transferred prior to day of life 3, and those who had an LP performed only after day of life 3. Logistic regression was used to determine the association between early LP and the incidence of severe IVH (IVH grades 3/4) by 28 days of life for each day of life from day 0 (birth) to day 3, adjusting for clinical covariates. Results: 106,461 infants were included: 754 received an LP on Day-0, 640 on Day-1, 559 on Day-2 and 483 on Day-3. Severe IVH occurred in 4% (4130/104,025) of the infants in the no LP group and 9% (217/2436) of the LP group. Severe IVH was higher for infants with early LP: adjusted OR (95% confidence interval) = 2.64 (1.96-3.54) on Day-0

2.21 (1.61-3.04) on Day-1

1.55 (1.03-2.34) on Day-2

and 2.25 (1.50-3.38) on Day-3. Conclusions: Early LP was associated with severe IVH in VLBW infants by 28 days of life. LP is either a surrogate for an unrecognized factor or is itself associated with an increased risk of IVH.
Keywords Infant, newborn
Cerebral hemorrhage
Lumbar puncture
Bacterial meningitis
xmlui.dri2xhtml.METS-1.0.item-coverage Clare
Language English
Date 2018
Published in Early Human Development. Clare, v. 117, p. 43983, 2018.
ISSN 0378-3782 (Sherpa/Romeo, impact factor)
Publisher Elsevier Ireland Ltd
Extent 1/jun
Origin http://dx.doi.org/10.1016/j.earlhumdev.2017.11.013
Access rights Closed access
Type Article
Web of Science ID WOS:000429392000001
URI https://repositorio.unifesp.br/handle/11600/54150

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