Objective: Intraventricular hemorrhage (IVH) and subsequent development of hydrocephalus are of the most serious complications of prematurity, with an enormous potential impact on mortality, morbidity and neurodevelopmental outcome. The aim of this study was to describe the outcomes of the preterm infants with severe IVH.

Material and Method: Eighty-four preterm infants, who born with a birth weight < 1500 g and diagnosed with severe IVH between 2014 and 2020, were retrospectively reviewed. The primary outcome were mortality, the development of posthemorrhagic hydrocephalus and motor outcome. Uni- and multivariate analysis were used to identify factors influencing the outcomes.

Results: Thirty patients (35.7%) died within the first three weeks of life, and severity of IVH and need for early red blood cell (RBC) transfusion were each independently associated with the death (p <0.05). Among the survivors, 36 patients developed posthemorrhagic hydrocephalus, for which the severity of IVH was independently a risk factor (p <0.01). Of 40 patients evaluated at least 18 months of corrected ages, 55% had varying degrees of motor disability. The need for early RBC transfusion and permanent ventriculoperitoneal shunt were each independently associated with severe motor disability (p <0.05).

Conclusion: The severity of IVH is associated with an increased risk of death, posthemorrhagic hydrocephalus and poor motor outcome. Need for early RBC transfusion in infants with severe IVH seems also to be associated with either death or severe motor disability in those survived, suggesting that it can be used by clinicians when counseling parents.