Intracranial Haemorrhage in Premature NeonatesEpidemiology and Prevention

Prematurity is the most important risk factor for intracranial haemorrhage (ICH). Many aetiological factors contribute to ICH in neonates, including trauma with labour, mode of delivery, acidemia, hypoxia, hypercarbia, immaturity of the coagulation system, change in newborn blood pressure, and newborn stress from resuscitation. Antenatal initiatives to prevent ICH have focused on advancing gestational age, pharmacological interventions, optimising acid-base status and limiting intrapartum trauma. Neonatal initiatives have focused on pharmacological and supportive measures which stabilise cerebral blood flow and oxygen delivery by local and systemic actions. The potential for pharmacological agents which could reduce capillary bleeding or act as antioxidants to further prevent ICH remain a pressing research need.