Predictive value of vascular endothelial growth factor in preterm neonates with intraventricular haemorrhage

Abstract

Objective: Intraventricular haemorrhage (IVH) is a major problem in premature infants. Our objective is to assess the early predictive value of vascular endothelial growth factor (VEGF) for development of IVH and management of its squeal in preterm neonates. Methods: We prospectively studied 150 preterm neonates (PT) less than 34 weeks gestation. Fifty of them completed the study. 30/50 developed IVH during follow up, and 20 did not. First 24 hours, and 3^rd day serum samples were collected. Cerebrospinal fluid (CSF) samples were withdrawn for 10 IVH patients. Results: Serum VEGF; both samples were increased in IVH compared to non-IVH group (P = 0.001). PHVD-group (n = 10) had higher VEGF in both samples than resolved IVH (P = 0.004), (P = 0.005). While, VEGF increased in the IVH group 2^nd sample compared to 1^st (P = 0.000), it decreased in non-IVH group, P = 0.033). Each 1 unit increase in 1^ST VEGF increased the risk of occurrence of IVH by 1.6%. 3^rd day VEGF at a cut-off value of 135 pg/ml is 96% sensitive and 100% specific to predict PHVD. Serum VEGF inversely correlated with TLC, pH, PO₂ and HCO₃, and positively correlated with PCo₂ and FiO₂. Conclusion: Serum VEGF predicts development of IVH and PHVD in PT neonates. Also, high CSF level of VEGF could predict the need for permanent shunt placement.

Keywords::

• Cerebrospinal fluid
• intraventricular haemorrhage
• post haemorrhagic ventricular dilatation
• preterm neonates
• vascular endothelial growth factor
• VEGF
• ventricular tap
• ventriculo-peritoneal shunt

Declaration of Interest: The authors report no declarations of interest.