{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:58:41Z","timestamp":1790384321112,"version":"4.1.0"},"reference-count":40,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2019,5,14]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To describe the trend and risk factors for severe intraventricular haemorrhage (IVH) among infants &lt;32 weeks gestation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Population-based cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Australia and New Zealand.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>All preterm infants &lt;32\u2009weeks gestation in the Australian and New Zealand Neonatal Network (ANZNN) from 1995 to 2012.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Comparison of IVH incidence between 6-year epochs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Overall IVH and severe IVH incidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 60\u2009068 infants were included, and overall survival to discharge increased from 89% to 93% over the three epochs. As the percentage of infants with IVH decreased from 23.6% to 21.3% and 21.4% (p&lt;0.001) from epoch 1 to 3, respectively, fewer survivors had severe IVH (4.0%, 3.3% and 2.8%, respectively, p&lt;0.001). Over time, there were fewer antenatal complications, higher antenatal steroid usage and more caesarean-section births. Fewer infants were intubated at birth, had low 5\u2009min Apgar score, had sepsis or pneumothorax needing drainage. Adjusted for perinatal confounders, there was significant reduction in odds of severe IVH from epoch 1 to 3 (adjusted OR (AOR) 0.8, 95% CI 0.7 to 0.9). Factors associated with development of severe IVH include no antenatal steroids (AOR 1.7, 95% CI 1.5 to 1.9), male (AOR 1.3, 95% CI 1.2 to 1.4), 5\u2009min Apgar score &lt;7 (AOR 2.0, 95% CI 1.9 to 2.2), intubated at birth (AOR 2.0, 95% CI 1.8 to 2.2), extremely low gestational age (AOR 4.0, 95% CI 3.7 to 4.4), outborn (AOR 1.6, 95% CI 1.5 to 1.8) and vaginal delivery (AOR 1.4, 95% CI 1.3 to 1.6).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Along with increased survival among infants born &lt;32 weeks gestation, the incidence of severe IVH has decreased over the 18 years, especially in the most recent period. This coincided with reduction in rates of risk factors for severe IVH development.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2018-316664","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T17:25:41Z","timestamp":1560533141000},"page":"145-150","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":93,"title":["Improving incidence trends of severe intraventricular haemorrhages in preterm infants &lt;32 weeks gestation: a cohort study"],"prefix":"10.1136","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-3610","authenticated-orcid":false,"given":"Kee Thai","family":"Yeo","sequence":"first","affiliation":[{"name":"Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia"},{"name":"Department of Neonatology, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reji","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia"},{"name":"Mount Gambier Hospital, Mount Gambier, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon SW","family":"Chow","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"School of Women\u2019s & Children\u2019s Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Bolisetty","sequence":"additional","affiliation":[{"name":"Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia"},{"name":"School of Women\u2019s & Children\u2019s Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Haslam","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Tarnow-Mordi","sequence":"additional","affiliation":[{"name":"National Health & Medical Research Council Trials Centre, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia"},{"name":"School of Women\u2019s & Children\u2019s Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,14]]},"reference":[{"key":"2025090511405776000_105.2.145.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2959"},{"key":"2025090511405776000_105.2.145.2","doi-asserted-by":"crossref","unstructured":"Inder TE PJ . 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