Introduction: Neonatal mortality is a major global concern, with prematurity contributing to a significant portion of these deaths. Intraventricular hemorrhage (IVH) is a key factor in both mortality and long-term morbidity among low birth weight (VLBW) infants however, the impact of IVH on neurodevelopmental outcomes, particularly in low-resource settings, remains poorly understood. Objectives: This study aimed to investigate the influence of IVH presence or absence in VLBW infants on developmental delay and neurological outcomes. Methods: We conducted a two-year prospective study at Mbale Regional Referral Hospital (MRRH) involving VLBW infants (≤2000 grams) at risk of IVH. Cranial ultrasounds were performed on recruitment day and days 3, 7, and 28 in the neonatal period. Developmental assessments occurred at 6, 18, and 24 months using the Malawi Development Assessment Tool (MDAT) and Hammersmith Infant Neurological Examination (HINE). Poor neurodevelopment was defined as MDAT development-for-age Z scores less than -2, and suboptimal neurological outcomes for HINE were scores equal to or less than 70 at 6 months and 73 at 18 and 24 months. Results Among 120 infants, survival rates were 67.5% at 28 days, 55.8% at 6 months, 51.7% at 18 months, and 44.2% at 24 months. Neurodevelopmental disability incidence was similar in IVH and non-IVH infants at 6, 18, and 24 months (p > 0.05), with no significant differences in mortality or disability. Conclusion Our findings showed IVH presence did not significantly impact neurodevelopmental outcomes. Addressing attrition and mortality challenges, larger, longer-term studies are required to assess neurodevelopmental implications.

Noella Okalany
University of Bergen
Uganda

Kathy Burgoine
Mbale Regional Referral Hospital
Uganda

Rachael Macleod
NHS
United Kingdom

Francis Okello
University of Bergen
Uganda

Ambrose Okibure
Varimetrics Group
Uganda