Obstetric factors associated with intracranial hemorrhage (ICH) in premature infants and antenatal prediction of ICH

: Obstetric factors associated with intracranial hemorrhage (ICH) were evaluated in 98 inborn premature infants of less than 1,500 gm birth weight or less than 32 weeks of gestation. ICH was detected in 25 (25.5%) of these infants by ultrasound sonography and/or computed tomography. No association of obstetric factors such as maternal age, parity, gravidity, premature rupture of the membrane, toxemia, placenta previa, fetal position, mode of delivery or fetal sex with ICH was noted. But the ICH group showed a higher incidence of placental abruption, infarction, infection and incompetent cervix than the non-ICH group. In addition, gestational ages and birth weights were less in the ICH group than in the non-ICH group, although differences were not significant except for the group with incompetent cervix (p less than 0.05). However, Apgar scores and FHR scores according to Krebs et al. for the ICH group were significantly lower than those for the non-ICH group. The two groups were distinguished by multivariable discriminant analysis of FHR scores, birth weights and gestational ages (discriminant efficiency, 3.74: F-value, 20.6: true positive ratio, 81.3%). These results suggested that antenatal prediction of ICH in premature infants was possible, but further studies are needed to elucidate the reliability of its prediction.