Factors Associated With Hydrocephalus After Pediatric Intraventricular Hemorrhage

stroke with hemorrhage
stroke with 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.

For more coverage of CNS 2016, go here.

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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.