Intraventricular haemorrhage (IVH) and associated clinical characteristics in outborn preterm infants <32 weeks undergoing neonatal transport in Western Australia: a retrospective cohort study (2011–2021)

Objectives To evaluate maternal, infant and transport factors associated with intraventricular haemorrhage (IVH) in outborn preterm infants Design Retrospective cohort study. Setting Newborn emergency transport service of Western Australia (NETS WA). Participants Preterm infants Outcomes Outcome was any IVH detected on cranial ultrasound on day 1 and day 7 of life. Perinatal data were analysed comparing infants with and without IVH using bivariate tests and logistic regression to examine differences between these groups. Results IVH occurred in 57/286 (19.9%) on day 1 and 53/275 (19.9%) on day 7; severe IVH occurred in 25/286 (8.7%) and 27/275 (9.9%), respectively. Infants with IVH had lower gestational age and birth weight, greater exposure to intra-amniotic inflammation and less antenatal steroid exposure. In multivariable analyses, intra-amniotic inflammation was associated with increased odds of IVH on day 1 (OR 2.47, 95% CI 1.10 to 5.44). Epinephrine use during resuscitation was associated with higher odds of IVH on day 1 (OR 4.88, 95% CI 1.49 to 17.5). Inotrope use during transport was associated with IVH on day 1 (OR 7.85, 95% CI 1.35 to 54.6) and day 7 (OR 9.11, 95% CI 1.32 to 72.9). Continuous positive airway pressure during transport was associated with lower odds of IVH on day 1 (OR 0.32, 95% CI 0.10 to 0.88). Transport mode, duration and timing intervals were not associated with IVH. Conclusions In outborn preterm infants <32 weeks’ gestation, IVH risk was more strongly associated with perinatal factors than transport characteristics. Collaboration across perinatal networks should aim to support optimal management during preterm labour birth.