{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:03:55Z","timestamp":1789772635807,"version":"4.0.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pulmonary hemorrhage is a severe respiratory complication with high mortality\n                        in preterm infants; no causal treatment exists. This study aimed to identify\n                        risk factors for pulmonary hemorrhage in extremely low birth weight infants\n                        (birth weight &lt;1,000 g) treated in a German neonatal unit and to relate\n                        these factors to a local three-fold increase in pulmonary hemorrhage\n                        incidence over 10 years.<\/jats:p>\n                  <jats:p>In this retrospective cohort study spanning approximately 10 years, 319\n                        extremely low birth weight infants (including 12 with pulmonary hemorrhage)\n                        were divided into low- and high-incidence periods. Perinatal characteristics\n                        and therapeutic measures were recorded, and associations between risk\n                        factors, time period, and pulmonary hemorrhage incidence were analyzed\n                        statistically.<\/jats:p>\n                  <jats:p>Multiple gestation (odds ratio: 23.83), small for gestational age (odds\n                        ratio: 7.01), a low 1-minute Apgar score (odds ratio: 1.57 per 1-point\n                        decrease), and higher fluid intake during the first 2 days of life (odds\n                        ratio: 1.36 per additional 10 mL\/kg\/d) were independent risk factors for\n                        pulmonary hemorrhage.<\/jats:p>\n                  <jats:p>A 1.5-fold increase in the small for gestational age rate over the study\n                        period may have contributed to the increased pulmonary hemorrhage incidence.\n                        Comparison of low- and high-incidence periods further suggested possible\n                        associations between an initial surfactant dose and use of binasal CPAP\n                        (Continous Positive Airway Pressure) devices. Based on these findings, a\n                        five-point catalog of preventive measures was developed.<\/jats:p>","DOI":"10.1055\/a-2954-5687","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:07:25Z","timestamp":1788822445000},"source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Hemorrhage in Extremely Low Birth Weight Infants: Risk\n                    Factors and Preventive Measures for an Increased Incidence"],"prefix":"10.1055","author":[{"given":"Jonas","family":"Fritsch","sequence":"additional","affiliation":[{"name":"Children\u2019s and Youth Hospital AUF DER BULT, Germany","place":["Hannover"],"department":["Department of Neonatology"]},{"name":"Ev. Hospital Witten, Germany","place":["Witten"],"department":["Department of Anesthesiology and Intensive Care Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Wiesner","sequence":"additional","affiliation":[{"name":"Hannover Medical School, Germany","place":["Hannover"],"department":["Institute for Biostatistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Guthmann","sequence":"additional","affiliation":[{"name":"Children\u2019s and Youth Hospital AUF DER BULT, Germany","place":["Hannover"],"department":["Department of Neonatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5735-4526","authenticated-orcid":false,"given":"Manuela F.","family":"Richter","sequence":"additional","affiliation":[{"name":"Children\u2019s and Youth Hospital AUF DER BULT, Germany","place":["Hannover"],"department":["Department of Neonatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1111\/apa.16127","article-title":"Pulmonary haemorrhage in neonates: Systematic review of management","volume":"111","author":"M E Barnes","year":"2022","journal-title":"Acta Paediatr"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s004310050998","article-title":"Pulmonary haemorrhage in infants with gestational age of less than 30 weeks","volume":"157","author":"M P De Carolis","year":"1998","journal-title":"Eur J Pediatr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.jped.2013.12.008","article-title":"Prevalence, risk factors and outcomes associated with pulmonary hemorrhage in\n                    newborns","volume":"90","author":"CH F Ferreira","year":"2014","journal-title":"J. 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Gezmu","year":"2023","journal-title":"Front Pediatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"105977","DOI":"10.1016\/j.earlhumdev.2024.105977","article-title":"Analysis of perinatal risk factors for massive pulmonary hemorrhage in very low\n                    birth weight infant: a nationwide large cohort database (Abstract)","volume":"191","author":"J K Jung","year":"2024","journal-title":"Early Hum Dev"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1038\/s41372-022-01464-9","article-title":"Pulmonary hemorrhage in extremely low birth weight infants: Significance of the\n                    size of left to right shunting through a valve incompetent patent foramen\n                    ovale","volume":"42","author":"J M Kappico","year":"2022","journal-title":"J Perinatol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1515\/jpm.1999.050","article-title":"Pulmonary hemorrhage in neonates of early and late 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Ahmad","year":"2019","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s12519-019-00322-7","article-title":"Perinatal risk factors for pulmonary hemorrhage in extremely low-birth-weight\n                    infants","volume":"16","author":"T T Wang","year":"2020","journal-title":"World J Pediatr"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"938431","DOI":"10.3389\/fped.2022.938431","article-title":"Association between pulmonary hemorrhage and CPAP failure in very preterm\n                    infants","volume":"10","author":"L Wang","year":"2022","journal-title":"Front Pediatr"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.prrv.2025.04.001","article-title":"Pulmonary hemorrhage in preterm infants born < 29 weeks\u2019 gestation: a\n                    population cohort study","volume":"57","author":"P R Jani","year":"2025","journal-title":"Paediatr Respir 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              and meta-analyses","volume":"100","author":"R C Silveira","year":"2024","journal-title":"J Pediatr (English Edition)"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1001\/jamapediatrics.2025.1025","article-title":"Active treatment vs expectant management of patent ductus arteriosus in preterm\n                    infants: a meta-analysis","volume":"179","author":"S Buvaneswarran","year":"2025","journal-title":"JAMA Pediatr"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2441","DOI":"10.1001\/jama.2015.6734","article-title":"Association between early screening for patent ductus arteriosus and in-hospital\n                    mortality among extremely preterm infants","volume":"313","author":"J-C Roz\u00e9","year":"2015","journal-title":"JAMA"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1089\/ther.2021.0036","article-title":"Advances in the prevention and treatment of neonatal hypothermia in early\n                    birth","volume":"12","author":"J Liu","year":"2022","journal-title":"Ther Hypothermia Temp Manag"}],"container-title":["Klinische 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