Frequent handling in the neonatal intensive care unit and intraventricular hemorrhage

H. S. Bada, S. B. Korones, E. H. Perry, K. L. Arheart, M. Pourcyrous, J. W. Runyan, G. D. Anderson, H. L. Magill, C. W. Fitch, G. W. Somes

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


The association between periventricular-intraventricular hemorrhage (PV-IVH) and frequent handling resulting from various neonatal intensive care procedures and routine interventions was evaluated in a prospective clinical study. Inborn premature babies with birth weight ≤1500 gm (n = 156) who did not have PV-IVH or who had grade 1 PV-IVH at ≤1 hour were randomly assigned to the reduced manipulation protocol (n = 62) or to standard care (n = 94). A bedside microcomputer-based data acquisition system was used to monitor the duration of rest or the number of interventions per day. Infants assigned to receive reduced manipulation spent a significantly higher percentage of time each day at rest than did those who received standard manipulation (p < 0.006). However, the incidence of grades 2 to 4 PV-IVH did not differ significantly (30% in the study vs 37% in the standard manipulation group). When we analyzed the effect of manipulation in relation to risk of PV-IVH, while taking into account other perinatal variables, standard manipulation was not associated with increased risk of grades 2 to 4 PV-IVH. However, low birth weight, maternal smoking, general anesthesia, early grade 1 PV-IVH, low hematocrit, lowest arterial oxygen pressure within the first 6 hours of life, and large base deficit at 6 hours of age all increased the relative risk of grades 2 to 4 PV-IVH.

Original languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalThe Journal of Pediatrics
Issue number1 PART 1
StatePublished - Jul 1990

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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