Factors Associated With Hydrocephalus After Pediatric Intraventricular Hemorrhage
Risks associated with certain NSAIDS and steroids warrant further investigation.
VANCOUVER – Several factors, including ethnicity, infection, and medication history impact risk of developing post-hemorrhagic hydrocephalus (PHH) in patients with intraventricular hemorrhage (IVH), according to data from a large retrospective study.
The study, led by Hannah Tully, MD, of Seattle Children's Hospital, was presented at the 2016 Child Neurology Society Annual Meeting, October 26-29, 2016 in Vancouver, British Columbia.
While PHH is a common complication of IVH, risk factors associated with its occurrence have not been well established.
In order to identify possible risk factors, Dr Tully and colleagues, analyzed data from a cohort of 20,887 infants (58% male) diagnosed with IVH between 2004 and 2014 through the Pediatric Hospital Information System.
Eleven percent of infants with IVH who lived at least a week developed PHH (n=2421). Notably, patients of Asian and Hispanic ethnicity had a reduced risk of developing PHH compared to white patients (hazard ratio [HR] 0.78; 95% confidence interval [CI], 0.69-0.87; HR 0.54; 95%CI, 0.34-0.87, respectively). Meningitis was also associated with an increased risk (HR 3.96; 95%CI, 3.01-5.21), as well as dopamine (HR 0.63; 95%CI, 0.53-0.75).
Factors associated with reduced risk of PHH included patent ductus arteriosus (RR 0.80; 95%CI, 0.75-0.86) and certain non-steroidal anti-inflammatory drugs, including indomethacin and IV ibuprofen (HR 0.70; 95%CI, 0.58-0.83; HR 0.65; 95%CI, 0.44-0.95). Methylprednisolone and prednisolone were also associated with reduced risk (RR 0.78; 95%CI, 0.62-0.98; RR 0.79; 95%CI, 0.64-0.98, respectively).
The distinctive risks associated with certain drugs is particularly interesting, and is worth exploring as possible modifiable risk factors in future investigations, the authors concluded.
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Tully H, Rue T, Traudt C, et al. Risk Factors for Post-Hemorrhagic Hydrocephalus Among Infants with Intraventricular Hemorrhage. Presented at: 2016 Child Neurology Society Annual Meeting. October 26-29, 2016; Vancouver, BC. Abstract 192.