Intraventricular Hemorrhage in preterm neonates transported to a Tertiary Care facility: Does distance and transport vehicle effect the occurrence of hemorrhage?

Background Germinal matrix-intraventricular hemorrhage (GMH-IVH) is a major morbidity in premature neonates, with higher incidence in outborn infants requiring transport. Objective To identify factors associated with high-grade GMH-IVH in outborn preterm neonates transported to UF Health. Methods This retrospective, single-center cohort study included 69 outborn neonates diagnosed with IVH between 2016 and 2021. Logistic regression and ANOVA models (parametric and nonparametric) were used to assess associations between transport-related factors and GMH-IVH severity. Results Among neonates born at ≤ 30 weeks’ gestation, both transport distance and duration were significantly associated with increased risk of high-grade GMH-IVH (p = 0.01). Mode of transport was not significantly associated. Lower gestational age and birth weight were also linked to higher GMH-IVH severity (p < 0.05). Conclusion Transport distance and duration may contribute to GMH-IVH severity in extremely preterm neonates. Early implementation of GMH-IVH prevention bundles at referring hospitals and use of head ultrasound during transport may help mitigate risk and guide early interventions.