Association between Germinal Matrix Hemorrhage and Perinatal Risk Factors in Preterm Neonates, in a Southwestern Nigerian Hospital

Aims: To determine the incidence of Germinal matrix hemorrhage (GMH) among preterm neonates and the associated perinatal risk factors.

Study Design: Prospective cross sectional study.

Place and Duration of Study: This study was carried out in the (two) neonatal units of Lagos University Teaching Hospital (LUTH), Idi-Araba, from May 2011 – April 2012.

Methodology: Transfontanelle Ultrasonography was done for 300 preterm neonates (136 male and 164 females) within the first 24 hrs of life and subsequently on the 2nd, 3rd, 4th and 7th days of life. Thereafter weekly until discharge or corrected 40 weeks. Sonographic findings and pertinent perinatal history from the case note of each neonate were documented using a proforma. Gestational age was determined from maternal dates (last menstrual period) and gestational assessment by Ballard score. Data were analyzed using IBM SPSS Statistic software, version 20.0 and Chi – square test with desired degree of accuracy at 0.05.

Results: GMH occurred in 95/300 neonates, giving an incidence of 31.7%. Anemia (33/50, p<0.001) and perinatal HIV exposure (100%, p<0.001) were the most significant risk factors. Antenatal corticosteroid administration had significant protective effect (p= 0.001). Gender however did not significantly determine the occurrence of GMH (p = 0.40).

Conclusion: The incidence of GMH in preterm neonates is higher than previously reported. Preventable perinatal risk factors are significant contributors. Antenatal steroid administration was found to be protective.