Trial reportDeutsches Arzteblatt international2013
Prospective risk factor monitoring reduces intracranial hemorrhage rates in preterm infants.
Trial report in Deutsches Arzteblatt international, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Singapore Neonatal Resuscitation Guidelines 2016.Singapore medical journal · 2017Guideline
- Umbilical Cord Milking Versus Delayed Cord Clamping in Infants 28 to 32 Weeks: A Randomized Trial.Pediatrics · 2023Trial
- The impact of central venous catheter use on long-term growth and neurobehavioral outcome in preterm children born < 29 weeks of gestation.Molecular and cellular pediatrics · 2026Article
- Article
- Golden hour(s) quality improvement protocols and their effect on outcomes in preterm infants ≤ 32 weeks of gestation: a scoping review.BMC pediatrics · 2025Article
- Quality improvement project to reduce intraventricular haemorrhage in very preterm infants failed due to increased life-sustaining intensive care at low gestational age.BMJ open quality · 2025Article
- Does midline head positioning decrease intraventricular hemorrhage or is it futile? Without a definitive trial, we will never know.World journal of pediatrics : WJP · 2025Article
- Sustained Reduction in Severe Intraventricular Hemorrhage in Micropremature Infants: A Quality Improvement Intervention.Children (Basel, Switzerland) · 2025Article
- Materials, Designs, and Implementations of Wearable Antennas and Circuits for Biomedical Applications: A Review.Micromachines · 2023Review
- Neuroprotection care bundle implementation is associated with improved long-term neurodevelopmental outcomes in extremely premature infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Prevention of severe brain injury in very preterm neonates: A quality improvement initiative.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Advancements in neonatology through quality improvement.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- Accounting for arterial and capillary blood gases for calculation of cerebral blood flow in preterm infants.European journal of pediatrics · 2022Article
- Impact of a "Brain Protection Bundle" in Reducing Severe Intraventricular Hemorrhage in Preterm Infants <30 Weeks GA: A Retrospective Single Centre Study.Children (Basel, Switzerland) · 2021Article
- Extremely low gestational age infants: Developing a multidisciplinary care bundle.Paediatrics & child health · 2021Article
- Evaluating the Effect of a Neonatal Care Bundle for the Prevention of Intraventricular Hemorrhage in Preterm Infants.Children (Basel, Switzerland) · 2021Article
- Precision Medicine in Neonates: A Tailored Approach to Neonatal Brain Injury.Frontiers in pediatrics · 2021Review
- Machine learning models for identifying preterm infants at risk of cerebral hemorrhage.PloS one · 2020Article
- Umbilical Cord Milking: A Review.Frontiers in pediatrics · 2018Review
- Consider using heparin.Deutsches Arzteblatt international · 2014Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntracranial 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.
methodsA 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).
resultsIn 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).
conclusionThe rate of brain hemorrhage in premature neonates can be considerably lowered by prospective monitoring of risk factors.
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