Abstract

Introduction: Neonatal intracranial haemorrhage is relatively common. The aim of our study was to describe the clinical characteristics and prognostic factors of neonatal intracranial haemorrhage at the National Children's Hospital Albert Royer (NCHAR) in Dakar.

Materials and methods: This was a descriptive study including all newborns hospitalised in the NCHAR neonatal intensive care unit between 1 January 2017 and 31 December 2021 for intracranial haemorrhage diagnosed on brain imaging.

Results: Eighty four newborns were collected, including 43 boys. The mean age of the newborns was 4.3 days (extremes of 32 minutes and 27 days). Clinical manifestations were dominated by respiratory distress (n=63; 75%) and neurological signs (n=23; 27.4%). Intra ventricular haemorrhage was more common (73 cases or 87%), 45 of which were grade 2, followed by isolated intra parenchymal haemorrhage (7 cases or 8.3%). Etiological factors were dominated by prematurity (n=50; 59.6%) and infections (n=42; 50%). Several aetiological factors (≥ 2) were found in 44 newborns (52.4%). Treatment included oxygen therapy (89.2%), blood transfusion (58.3%), osmotherapy (10.7%), anticonvulsants (22.6%). The evolution in hospital was unfavourable in 39 newborns, including 24 premature. The risk factors for death were the presence of respiratory distress with an odd ratio of 0.27 [CI 0.09-0.83] and a P value of 0.016. Thirty newborns (66.7%) were followed up after hospitalization for a mean of 14 months (extremes of 2 weeks to 53 months). An evolution without sequelae was noted in 27 newborns.

Conclusion: Neonatal intracranial haemorrhages predominate in premature babies and are a major cause of morbidity and mortality in the acute phase.