Predictors of severity of subgaleal hemorrhage

Supaporn Dissaneevate


Background: Subgaleal hemorrhage (SGH) from birth injury can be a lethal complication in severe cases.Objectives: To compare risk factors and outcomes of SGH between neonates with serious complications (SC) and nonserious complications (NSC).Methods: We conducted a descriptive retrospective study in a neonatal intensive care unit. All neonates were born between January 1982 and December 2014. The SC group was defined as neonates who had either shock or blood transfusion, whereas those in the NSC group did not.Results: The incidence of SGH was 3.4 per 1,000 live births and 20.5 per 1,000 vacuum-assisted deliveries. We included 208 neonates in our study: 119 (57.2%) in the SC group and 89 (42.8%) in the NSC group. The mean (standard deviation) gestational age of the SGH neonates was 38.7 (1.6) weeks and their birth weight was 3275 (441.9) g. Univariate analysis showed gestational age, preterm, body length, Apgar score at 1 minute, and birth asphyxia in the SC neonates were significantly different from the NSC neonates. Multivariate analysis showed the SC neonates were significantly associated with preterm birth (P < 0.001) and birth asphyxia (P = 0.03) compared those in the NSC group. Anemia, jaundice, intensive phototherapy, length of hospital stay, and costs were higher in the SC neonates than in the NSC neonates (P < 0.001); however, only one neonate in the SC group died.Conclusions: Preterm birth and birth asphyxia are risk factors for SC in neonates with SGH, who need early detection, prompt treatment, and frequent monitoring.
Keywords: Birth injuries, hematoma, newborn, subaponeurotic hemorrhage, subgaleal hemorrhage

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