Prospective Risk Factor Monitoring Reduces Intracranial Hemorrhage Rates in Preterm Infants
Bibliographic record
Abstract
BACKGROUND: Intracranial hemorrhage occurs in 20% to 25% of neonates born before the 30th week of gestation or weighing less than 1500 grams at birth. These hemorrhages carry a risk of long-term neurocognitive damage. Measures for lowering the incidence of intracranial hemorrhage were evaluated. METHODS: A working group at the University of Ulm, Germany, developed a prospective monitoring program for risk factors and a bundle of measures including altered clinical approaches to delivery, initial care of the neonate in the delivery room immediately after birth, and intensive care in the first few days thereafter. Adherence to these measures was checked once per week. The evaluation was performed prospectively for a period of 23 months (August 2010 to July 2012) with a 31-month period of historical controls (January 2008 to July 2010). RESULTS: In the reference period before the intervention was introduced, 263 neonates weighing less than 1500 grams and with a median (quartile) gestational age at birth of 27.4 (25.4-29.9) weeks were treated. The incidence of intracranial hemorrhage was 22.1%, and that of high-grade hemorrhage was 9.1%. The mortality was 6.1%, and the rate of survival without brain hemorrhage was 74.5%. After the bundle of preventive measures was introduced, 191 neonates weighing less than 1500 grams and with a median (quartile) gestational age at birth of 28.0 (26.0, 30.3) weeks were treated. The incidence of intracranial hemorrhage dropped to 10.5% (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.25-0.73); the incidence of high-grade hemorrhage dropped to 3.7% (OR 0.36; 95% CI 0.14-0.89). The mortality was no different at 6.3%, and 85.3% of the children survived without a hemorrhage (OR 1.95, 95% CI 1.20-3.15). After statistical adjustment for higher gestational age, the OR for intracranial hemorrhage (IVH) was 0.49 (0.28-0.86) and the probability of survival without IVH improved (OR 1.68, 95% CI 1.01-2.81). CONCLUSION: The rate of brain hemorrhage in premature neonates can be considerably lowered by prospective monitoring of risk factors.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.003 |
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; both teacher heads agree on what is shown here.
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".