Neurobehavioral consequences of intraventricular hemorrhage in the very low birthweight infant

We assessed the effect of periventricutar-intraventricutar hemorrhage (IVH) on neurobehavioral examination in a group of very low birth weight (VLBW) infants to identify differences between these infants and control infants without IVH. Eleven VLBW infants who had IVH (birth weight 859 ± 217 g, gestational age 26 ± 2 weeks) and 19 others who did not, (birth weight 1043 ± 237 g, gestational age 28 ± 2 weeks) served as controls. The Standardized Neurobehavioral Assessment of the Preterm Infant (NAPI) was performed at 34-36 weeks conceptional age, and the results were expressed as a ratio of normative data. We found that infants who had suffered from IVH were hypertonic in the lower extremities (popliteal angle ratio score 1.71 ± 0.80) as compared to control infants (popliteal angle ratio score 1.19 ± 0.58, p < 0.05). Control infants scored tower in alertness (0.72 ± 0.37) in comparison to IVH infants (alertness score 1.10 ± 0.27, p < 0.05). No significant differences were seen in scarf sign, general motor development, irritability, cry quality and sleep time. We speculate that hypertonicity of tower extremities may be an early indicator of motor problems in infants with IVH. In addition, identifying hypertonicity before discharge from the nursery may allow more appropriate developmental care for these infants.