Risk Factors and Outcomes of Pulmonary Hemorrhage in Preterm Infants born before 32 weeks.

Background: Pulmonary hemorrhage (PH) is a catastrophic event associated with significant morbidity and mortality among preterm infants. Understanding PH risk factors in preterm newborns, particularly those in low-to-middle-income countries like Vietnam, remains limited. This study aimed to investigate the risk factors and short-term outcomes of PH in very preterm infants. Methods: We conducted an observational study of newborns aged < 72 hours with gestational age < 32 weeks, admitted to our unit from April 1, 2018 to March 31, 2019. Results: Of 118 recruited newborns, 28 (23.7%) had PH. The logistic regression analysis showed that intubation within 24 first hours, blood transfusion, and coagulation disorders within the first 3 days were risk factors for PH (aOR = 4.594, 95% CI = 1.200-17.593; aOR = 5.394, 95% CI = 1.243-23.395 and aOR = 7.242 95% CI = 1.838-28.542, respectively). Intra-ventricular hemorrhage (IVH) and mortality rates were higher in patients with PH compared to those without (p<0.001). The length of invasive ventilation was longer in the PH group (p<0.001). Conclusion: We have identified intubation, blood transfusion, and coagulation disorders shortly after birth as risk factors for PH in very preterm infants, which was associated with increased mortality and occurrence of IVH.