Burden of intraventricular haemorrhage among preterm neonates in Tanzania: A prospective observational study
Résumé
ABSTRACT Background Intraventricular haemorrhage (IVH) is a common intracranial complication of preterm neonates, especially those born before 32 weeks of gestation, and poses a high risk for morbidity with lifelong neurological disability. IVH remains a dilemma in low-resource settings, where access to high-quality prenatal and neonatal care is very limited. Cranial ultrasound (USS) remains an accessible imaging tool for detection of IVH. This study aimed to determine the burden and factors associated with IVH among preterm neonates admitted at a tertiary hospital in Tanzania. Methodology This was a prospective observational study on admitted preterm neonates born at gestational age (GA) of less than 37 weeks from March 2024 to February 2025. Cranial USS was performed to detect and grade IVH using the Papile Classification. Univariate and multivariate logistic regression was used to determine factors associated with IVH. Results IVH was prevalent in 96 of the 410 preterm neonates (23.4%). Majority (69.8%) presented with IVH grade I. Level of agreement for IVH grading was near perfect between the two reviewers. Independent risk factors for IVH on multivariate analysis were very low birth weight (VLBW) (aOR=7.2, 95%CI=2.1-24.8), extremely low birth weight (ELBW) (aOR= 6.3, 95%CI=1.7-23.1), respiratory distress syndrome (RDS) (aOR=2.3, 95%CI= 1.2-4.6), preterm premature rupture of membranes (PPROM) (aOR=2.3, 95%CI=1.2-4.4). Conclusions There is still a significant IVH burden with low grade IVH predominating in Tanzania. Modifiable risk factors associated with IVH included RDS and PPROM which can be potentially be targeted with interventions to reduce IVH.
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