Intraventricular Hemorrhage: Risk Factors and Association With Patent Ductus Arteriosus Treatment in Extremely Preterm Neonates
Bibliographic record
Abstract
Objectives To assess maternal and neonatal risk factors for intraventricular hemorrhage (IVH). To examine the association of patent ductus arteriosus (PDA) and its treatment with IVH and its severity. Study design Prospective cohort study of 495 neonates <29+0 weeks, admitted to a Level III Neonatal Intensive Care Unit (NICU) in Calgary, Canada, between 2013 and 2016, who had a head ultrasound in the first 7 days of life. A subset analysis included 258 neonates who had early cardiac imaging. The primary study outcome was severity of IVH. Tests used were two-sided and significance was defined as p-value <0.05. Results Of the 495 neonates, 121 (24.4%) had IVH of any grade and 48 (9.7%) had severe IVH. Identified risk factors are small birth gestation and weight, lack of antenatal corticosteroids, being outborn, vaginal delivery, maternal chorioamnionitis, respiratory distress syndrome, CO2 fluctuations, sedation, acidosis, inotropes or saline boluses use, and bicarbonate/THAM therapy. Medical treatment was received in 194 (39%) neonates. A PDA requiring treatment was associated with a higher risk of IVH. There was no significant difference in the incidence of IVH between neonates with early treatment of PDA compared to late, however early indomethacin treatment was associated with decreased severity of IVH. In the secondary analysis, 142 (55%) neonates had a hemodynamically significant PDA (Hs-PDA), and of those with severe IVH, 18 (55%) had a Hs-PDA; this is clinically but not statistically significant. Conclusions Identified risk factors should be the aim of IVH reduction bundles. Early indomethacin treatment decreases IVH severity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".