| Keywords [eng] |
intraventricular hemorrhage, ELBW, VLBW, preterm infant, pathogenesis, risk factors, diagnosis, neurodevelopmental outcomes, treatment |
| Abstract [eng] |
Background: Intraventricular hemorrhage is a major complication in extremely low birth weight and very low birth weight babies, contributing significantly to neonatal morbidity and mortality. The aim of this study is to provide an overview of current knowledge on the incidence, pathophysiology, risk factors, diagnosis, management, prevention, and long-term outcomes of intraventricular hemorrhage in this vulnerable population and to establish measures to improve the prognosis in affected neonates. A systematic evaluation of recent studies highlights the impact of perinatal care strategies on reducing intraventricular hemorrhage incidence. Despite advancements in neonatal medicine, high grades of intraventricular hemorrhage remain associated with adverse neurodevelopmental outcomes. Method: A literature review was conducted with a total of 57 studies. Results: This review included 58 studies published between 2014 and 2025. IVH remains a common complication in ELBW and VLBW infants, with severe cases (Grades III–IV) affecting up to 20% of this population. Key risk factors identified across studies include extreme prematurity, low birth weight, respiratory distress, mechanical ventilation, and fluctuations in cerebral blood flow. Diagnosis is most often made using cranial ultrasound, with MRI providing additional structural details in selected cases. A range of management strategies, such as antenatal corticosteroids, delayed cord clamping, and gentle ventilation, were associated with reduced IVH incidence. Importantly, across the reviewed literature, the most consistent and effective approach to prevention was the implementation of standardized care bundles, evidence-based guidelines, and staff education to reduce clinical variability. Short-term complications included posthemorrhagic ventricular dilation and hydrocephalus, while long-term outcomes often involved neurodevelopmental delay, motor impairments, and cognitive deficits. Because of the interactions between prematurity-related vulnerabilities, the lack of effective treatments, and the possibility of complications, IVH is still difficult to prevent and treat. Conclusion: Intraventricular hemorrhage remains a serious complication in preterm neonates, particularly those with extremely low birth weight and very low birth weight. Long-term neurological deficits and high morbidity are linked to this condition. The incidence of intraventricular hemorrhage in preterm newborns remains a major concern, even with advancements in neonatal care. The most consistent prevention strategy identified in the literature was the implementation of structured care bundles, standardized guidelines, and ongoing staff education. These approaches reduce variability in care and offer the best potential. To further improve outcomes in this susceptible population, future research should place a high priority on the early identification of high-risk neonates and the creation of innovative neuroprotective techniques. To develop more individualized and efficient treatment plans, future research should also examine the influence of environmental and genetic factors on the development of intraventricular hemorrhage. More research should be focused on novel preventive and therapeutic approaches to improve prognosis in affected neonates. Enhancing intraventricular hemorrhage management and prevention continues to be a top priority for neonatal care of preterm infants. |
