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Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants.

Publication ,  Journal Article
Testoni, D; Hornik, CP; Guinsburg, R; Clark, RH; Greenberg, RG; Benjamin, DK; Smith, PB
Published in: Early Hum Dev
February 2018

BACKGROUND: Lumbar puncture (LP) is the gold standard for diagnosing meningitis; however it is unknown whether early LP (≤3days of life) is associated with increased risk of intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants. OBJECTIVE: To determine whether early LP in VLBW infants is associated with severe IVH. METHODS: VLBW infants from a cohort of 1,158,789 infants discharged from 382 neonatal intensive care units (1997-2015) were enrolled. EXCLUSION CRITERIA: infants with major congenital anomalies, outborns, died/transferred prior to day of life 3, and those who had an LP performed only after day of life 3. Logistic regression was used to determine the association between early LP and the incidence of severe IVH (IVH grades 3/4) by 28days of life for each day of life from day 0 (birth) to day 3, adjusting for clinical covariates. RESULTS: 106,461 infants were included: 754 received an LP on Day-0, 640 on Day-1, 559 on Day-2 and 483 on Day-3. Severe IVH occurred in 4% (4130/104,025) of the infants in the no LP group and 9% (217/2436) of the LP group. Severe IVH was higher for infants with early LP: adjusted OR (95% confidence interval)=2.64 (1.96-3.54) on Day-0; 2.21 (1.61-3.04) on Day-1; 1.55 (1.03-2.34) on Day-2; and 2.25 (1.50-3.38) on Day-3. CONCLUSIONS: Early LP was associated with severe IVH in VLBW infants by 28days of life. LP is either a surrogate for an unrecognized factor or is itself associated with an increased risk of IVH.

Duke Scholars

Published In

Early Hum Dev

DOI

EISSN

1872-6232

Publication Date

February 2018

Volume

117

Start / End Page

1 / 6

Location

Ireland

Related Subject Headings

  • Spinal Puncture
  • Pediatrics
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Female
  • Cerebral Intraventricular Hemorrhage
  • 5201 Applied and developmental psychology
  • 3215 Reproductive medicine
 

Citation

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Testoni, D., Hornik, C. P., Guinsburg, R., Clark, R. H., Greenberg, R. G., Benjamin, D. K., & Smith, P. B. (2018). Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants. Early Hum Dev, 117, 1–6. https://doi.org/10.1016/j.earlhumdev.2017.11.013
Testoni, Daniela, Christoph P. Hornik, Ruth Guinsburg, Reese H. Clark, Rachel G. Greenberg, Daniel K. Benjamin, and P Brian Smith. “Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants.Early Hum Dev 117 (February 2018): 1–6. https://doi.org/10.1016/j.earlhumdev.2017.11.013.
Testoni D, Hornik CP, Guinsburg R, Clark RH, Greenberg RG, Benjamin DK, et al. Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants. Early Hum Dev. 2018 Feb;117:1–6.
Testoni, Daniela, et al. “Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants.Early Hum Dev, vol. 117, Feb. 2018, pp. 1–6. Pubmed, doi:10.1016/j.earlhumdev.2017.11.013.
Testoni D, Hornik CP, Guinsburg R, Clark RH, Greenberg RG, Benjamin DK, Smith PB. Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants. Early Hum Dev. 2018 Feb;117:1–6.
Journal cover image

Published In

Early Hum Dev

DOI

EISSN

1872-6232

Publication Date

February 2018

Volume

117

Start / End Page

1 / 6

Location

Ireland

Related Subject Headings

  • Spinal Puncture
  • Pediatrics
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Female
  • Cerebral Intraventricular Hemorrhage
  • 5201 Applied and developmental psychology
  • 3215 Reproductive medicine