Does transport affect the incidence of intraventricular hemorrhage in preterm infants?

Objective: Preterm infants are prone to intraventricular hemorrhage. They may suffer from significant morbidity and mortality particularly in those with high-grade hemorrhage. Our objective was to determine the incidence of intraventricular hemorrhage in premature infants transported to a tertiary center compared with those delivered at the level III facility. Methods: We evaluated all premature infants admitted to neonatal intensive care units affiliated with Shiraz University of Medical Sciences from April 2008 through April 2009. Neonatal transports from 20 facilities were compared with those delivered at the same centers’ level III facility with respect to intraventricular hemorrhage. Serial neonatal brain sonographies were performed on admission, 7th and 30th day post admission. Results: From a total of 161 premature neonates, 96 were inborn and 65 were outborn. Intraventricular hemorrhage was significantly higher in transported infants ( 24 of 96 inborn infants or 25% and 36 of 65 outborn neonates or 55.4% ) This difference was statistically significant (p< 0.001) Conclusion: We found that transported neonates had a higher risk for intraventricular hemorrhage compared to those born at the level III facility. Our data emphasizes the importance of improving teams for neonatal transfer. Ideally, high-risk pregnant women should be transferred before delivery to a perinatal center capable of caring for both the mother and infant.