Acute Kidney Injury, Fluid Balance and Risks of Intraventricular Hemorrhage in Premature Infants

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Objective: Evaluate association between fluid balance and intraventricular hemorrhage (IVH). Study design: Retrospective review of infants <30 weeks gestation admitted to Kentucky Children’s Hospital Neonatal Intensive Care Unit. Results: Infants with acute kidney injury (AKI) had a 2.4-fold increased risk of IVH (OR 2.38, 95% CI 1.46–3.87) and a 3.5-fold increased risk of severe IVH (OR 3.45, 95% CI 1.98–6.04). Infants above birthweight on day 4 had a 1.9-fold increased risk of IVH (OR 1.86, 95% CI 1.05–3.27) and a 2.0-fold increased risk of severe IVH (OR 1.96, 95% CI 1.03–3.74). When controlling for confounding factors, infants with AKI or above birthweight on day 4 had a 4.6-fold (aOR 4.60, 95% CI 1.80–11.78) and 3.0-fold (aOR 2.96, 95% CI 1.01–8.65) increased risk of severe IVH, respectively. Conclusion: Infants with AKI during the first week of life had a higher association of severe IVH even after controlling for confounding factors.