Intracranial hemorrhage occurs commonly in very-low-birthweight babies, and may account for many of the developmental handicaps seen in graduates of neonatal intensive care units. The goal of this case-control study of germinal matrix hemorrhage in very-low-birthweight babies is to identify exposures and characteristics (of the babies and their mothers) which if eliminated or modified might result in a reduction in the occurence of this disorder. Subjects will have been admitted to the neonatal intensive care units at Children's Hospital, the Brigham and Women's Hospital, and the Beth Israel Hospital, weigh less than 1.75 kilograms at birth, and had an ultrasonogram. Cases for each study will have documented evidence if germinal matrix hemorrhage. Controls will have sonographic evidence that they do not have germical matrix hemorrhage. Data about antenatal risk factors will be obtained from interviews of mothers and review of obstetricians' office records. Information about perinatal variables will be obtained from detailed review if delivery and neonatal intensive care unit charts. Data analysis will incluse multivariate techniques, some of which employ models with variables entered in a temporal sequence) i.e., antenatal, then delivery variables, then postnatal variables in theorder in which they occurred). Many of the hypotheses to be tested, especially those about antenatal risk factors have been generated in studies of hemorrhages on babies who died. This proposal is unique in emphasizing antenatal factors and in routinely obtaining detailed information from mothers, usually before the existence or absence if a hemorrhage has been established.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS020658-03
Application #
3401175
Study Section
Epidemiology and Disease Control Subcommittee 3 (EDC)
Project Start
1984-04-01
Project End
1987-03-31
Budget Start
1986-04-01
Budget End
1987-03-31
Support Year
3
Fiscal Year
1986
Total Cost
Indirect Cost
Name
Children's Hospital Boston
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115
Leviton, A; Kuban, K C; Pagano, M et al. (1993) Antenatal corticosteroids appear to reduce the risk of postnatal germinal matrix hemorrhage in intubated low birth weight newborns. Pediatrics 91:1083-8
Van Marter, L J; Pagano, M; Allred, E N et al. (1992) Rate of bronchopulmonary dysplasia as a function of neonatal intensive care practices. J Pediatr 120:938-46
Leviton, A; Nelson, K B (1992) Problems with definitions and classifications of newborn encephalopathy. Pediatr Neurol 8:85-90
Leviton, A; Pagano, M; Kuban, K C et al. (1991) The epidemiology of germinal matrix hemorrhage during the first half-day of life. Dev Med Child Neurol 33:138-45
Leviton, A; Fenton, T; Kuban, K C et al. (1991) Labor and delivery characteristics and the risk of germinal matrix hemorrhage in low birth weight infants. J Child Neurol 6:35-40
Krishnamoorthy, K S; Kuban, K C; Leviton, A et al. (1990) Periventricular-intraventricular hemorrhage, sonographic localization, phenobarbital, and motor abnormalities in low birth weight infants. Pediatrics 85:1027-33
Van Marter, L J; Leviton, A; Kuban, K C et al. (1990) Maternal glucocorticoid therapy and reduced risk of bronchopulmonary dysplasia. Pediatrics 86:331-6
Pagano, M; Leviton, A; Kuban, K (1990) Early and late germinal matrix hemorrhage may have different antecedents. Eur J Obstet Gynecol Reprod Biol 37:47-54
Van Marter, L J; Leviton, A; Allred, E N et al. (1990) Hydration during the first days of life and the risk of bronchopulmonary dysplasia in low birth weight infants. J Pediatr 116:942-9
Leviton, A; Pagano, M; Kuban, K C (1988) Etiologic heterogeneity of intracranial hemorrhages in preterm newborns. Pediatr Neurol 4:274-8