039. Degree of ventriculomegaly predicts school-aged functional outcomes in preterm infants with intra-ventricular hemorrhage

Authors: Grace Yee Yan Lai, MD

Greater ventriculomegaly in preterm infants with intraventricular hemorrhage (IVH) has been associated with worse neurodevelopmental outcomes in infancy. We aim to explore the relationship between ventriculomegaly and school-age functional outcome.Methods: Retrospective review of preterm infants with Grade III/IV IVH from 2006-2020. Frontal occipital horn ratio (FOHR) was measured on imaging throughout hospitalization and last available follow-up scan. Pediatric Cerebral Performance Category (PCPC) scale was used to assess functional outcome at ?4 years. Ordinal logistic regression was used to determine the relationship between functional outcome and FOHR at time of neurosurgery consult, neurosurgical intervention, and last follow-up scan while adjusting for confounders.
134 infants had Grade III/IV IVH. FOHR at consult was 0.62±0.12 and 0.75±0.13 at first intervention (p < 0.001). On univariable analysis, maximum FOHR, FOHR at last follow-up scan, and at neurosurgery consult predicted worse functional outcome (p < 0.01). PVL, longer hospital admission, and gastrotomy/tracheostomy tube also predicted worse outcome (p < 0.05). PVL, maximum FOHR, and FOHR at consult remained significant on multivariable analysis (p < 0.05). Maximum FOHR of 0.61 is a fair predictor for moderate-severe impairment (AUC 75%, 95%CI:62-87%).
Greater ventricular dilatation and PVL were independently associated with worse functional outcome in Grade III/IV IVH regardless of neurosurgical intervention.