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The Incidence of Symptomatic Intracranial Hemorrhage in Term Appropriate-for-gestation-age Infants

Department of Obstetrics and Gynecology, Beth Israel Hospital, Charles A. Dana Biomedical Research Institute, Harvard Medical School, Boston, Massachusetts

D. Acker

Department of Maternal and Child Health and Aging, Harvard School of Public Health, Boston, Massachusetts

R. Tuomala

Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts

E. Brown

Department of Newborn Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts

Symptomatic intracranial hemorrhage in term infants is rare. In over 23,000 deliveries the authors were only able to find 12 diagnosed cases for an incidence of 5.9/10,000 livebirths (2,500 g and 37 weeks' gestation). No consistent clinical patterns were identified. However, the obstetrical risk factors were a precipitate delivery, a second stage of more than 2 hours, the use of pitocin, and a forceps delivery. The number of cases of asymptomatic ICH was unknown because routine surveillance was not done. Furthermore, some infants may have become symptomatic following discharge, which may have resulted in an undercounting of the incidence of ICH. Most infants, however, became symptomatic by the second day.

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