WEIGHING PRETERM INFANTS AND INCIDENCE OF INTRAVENTRICULAR HEMORRHAGE

University Of Wisconsin Madison, Madison WI

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Abstract

This is a pilot study comparing the incidence of intraventricular hemorrhage (IVH) in preterm infants of less than 33 weeks postconceptual age who are weighed daily during the first five days of life, with a similar group which is not weighed. IVH, defined as bleeding of the fragile immature vascular structures of the germinal matrix of the premature infant's brain, is the most common type of intracranial hemorrhage seen in neonates. Recent literature suggests that IVH develops when reperfusion of cerebral vessels follows a hypoxic event affecting the germinal matrix. This fluctuation in cerebral blood flow can be correlated with systemic blood pressure changes, due to impaired autoregulation of cerebral blood flow characteristic of the preterm infant. Most IVH occurs within the first four postnatal days. IVH is most significant for its adverse effect on long-term developmental outcomes. Strategies to minimize cerebral blood flow fluctuation, such as minimal handling protocols, have been proposed. One recent article suggests avoidance of weighing as part of the strategy to minimize IVH incidence. Weighing of infants is a routine daily practice in Neonatal Intensive Care Units (NICUs). The safety and utility of this practice has not been widely questioned. But for preterm infants, the risk of IVH is increased with every intervention that precipitates cerebral blood volume variability. Weighing on a freestanding scale of the type utilized in most NICUs may indeed be an unnecessary stressor which augments risk of IVH. "