Risk factors for early intraventricular hemorrhage in low birth weight infants Laura R. M e n t , MD, William Oh, MD, Alistair G. S. Philip, MD, Richard A. Ehrenkranz, MD, Charles C. D u n c a n , MD, W a l t e r Allan, MD, K e n n e t h J. W. Taylor, MD, Karen Schneider, MPH, Karol H. Katz, BS, a n d Robert W. M a k u c h , PhD From the Departments of Pediatrics, Neurology, Surgery, Diagnostic Imaging, and Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut, the Department of Pediatrics, Brown UniversitySchool of Medicine, Providence, Rhode Island, and the Departments of Pediatrics and Neurology, Maine Medical Center, Portland Because earlier studies suggested that preterm infants with germinal matrix h e m o r r h a g e or intraventricular hemorrhage or both (GMH/IVH) present within the first 12 postnatal hours are at greatest risk for the d e v e l o p m e n t of high-grade h e m o r r h a g e and n e u r o d e v e l o p m e n t a l disability, we e x a m i n e d the risk factors for this insult a m o n g 229 neonates of 600 to 1250 gm birth weight in a multicenter study. All had e c h o e n c e p h a l o g r a p h y (ECHO) within the first 11 hours and serially for the next 20 days; risk factor data were c o l l e c t e d prospectively. Forty-three infants had GMH/IVH within the first 5 to 11 hours (mean a g e at ECHO 7.7 hours): 18 GMH and 21 g r a d e II, I g r a d e III, and 3 g r a d e IV IVH. One hundred eighty-six infants did not have GMH/IVH at a mean a g e of 7.9 hours. Both groups of infants were similar in birth weight, gestational age, maternal risk factors, cord pH values, and surfactant therapy before ECHO. The group with early IVH had more vertex presentations than the group without early IVH (79% vs 55%, p = 0.043), less maternal tocolytic use (42% vs 60%, p = 0.029), and more vaginal deliveries (67% vs 44%, p = 0.005). in the first 21 days, severe IVH d e v e l o p e d in 12 infants with early IVH and in 6 infants without early IVH (p