Developmental Delays and Therapies in Grades I and II Intraventricular Hemorrhage
Abigail Ghorbani1, Sarah Wilson1
1McGovern Medical School at UTHealth Houston
Objective:

To study the prevalence of developmental delays and need for therapies in infants with grades I and II intraventricular hemorrhage (IVH).

Background:

IVH is divided into four groups by severity, from mildest (grade I) to most severe (grade IV). While grades III and IV are known to contribute to significant developmental delays, developmental outcomes for infants with grades I and II remain unclear. The predominant opinion is that grades I and II IVH have little to no effect on development, but few studies have tracked this population.

Design/Methods:

Retrospective analysis of 180 neonatal intensive care unit (NICU) patients revealed 48 infants with grade I or II IVH. Developmental outcomes and therapies were compared between patients with and without grade I or II IVH.

Results:

Developmental delay was noted in 50% of the 34 infants with grade I IVH (vs. 43.8% of all other NICU infants) and in 64.3% of the 14 infants with grade II IVH (vs. 43.4% of all other NICU infants). Motor delays, however, were no more common among grades I and II infants. While grade II IVH infants were more likely to receive physical therapy or occupational therapy (92.9% and 85.7%, vs. 75.3% and 60.8% for all other infants), grade I infants were no more likely to receive either of these therapies. Of note, grades I and II IVH infants were more likely to have been born prematurely (88.2% and 92.9%, vs. 79.1% of infants without grades I or II).

Conclusions:

Infants born with grade I IVH experienced minimal delays compared to all other NICU infants. Those with grade II IVH, however, had greater likelihood of developmental delays and received more therapies than other NICU infants. This suggests a distinction in outcome between grades I and II IVH, not previously reported in the literature.

10.1212/WNL.0000000000204685