Neurodevelopmental Trajectories and Neurodevelopmental Disorders Following Neonatal Intracranial Hemorrhage: A Long-Term Follow-Up Study and Analysis of Influencing Factors.
Lin S, Yu R, Ding Z, Lin Z • Actas espanolas de psiquiatria • 2026
Although neurodevelopmental outcomes exhibit gradual improvement following neonatal ICH, a substantial proportion of affected children continue to experience long-term neurodevelopmental abnormalities and disorders, with parenchymal hemorrhage, Papile Grade IV, low birth weight, and perinatal asphyxia identified as independent risk factors.
Key Findings
Results
At the end of 3-5 years of follow-up, 43.75% of children with neonatal intracranial hemorrhage had neurodevelopmental abnormalities and 38.75% had neurodevelopmental disorders.
80 neonates with ICH from the NICU of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University were followed for 3-5 years.
Neurodevelopmental abnormality was defined as any Developmental Quotient (DQ) <85 on the Gesell Developmental Schedules.
Neurodevelopmental disorders were defined according to the diagnostic criteria for Brain Damage Syndrome (BDS).
Results
Gesell Developmental Schedule total scores increased gradually across the 1-, 3-, and 5-year follow-ups, with significant differences between time points.
Mean total scores were 72.36 ± 5.84 at 1 year, 81.57 ± 6.24 at 3 years, and 86.71 ± 5.93 at 5 years.
The difference across time points was reported as F = 113.78, p < 0.001.
Results
In univariate analysis, hemorrhage severity and location, birth weight, gestational age, perinatal asphyxia, and concurrent hydrocephalus were significantly associated with neurodevelopmental disorders.
Papile grade of hemorrhage (p < 0.001), hemorrhage location (p < 0.001), birth weight (p < 0.001), gestational age (p < 0.001), and perinatal asphyxia (p < 0.001) were significant.
Concurrent hydrocephalus was also significantly associated (p = 0.003).
Results
Multivariate logistic regression identified parenchymal hemorrhage, Papile Grade IV, birth weight <2500 g, and perinatal asphyxia as independent risk factors for neurodevelopmental disorders after neonatal ICH.
Parenchymal hemorrhage: OR = 4.215, 95% CI 1.723-10.312, p = 0.002.
Papile Grade IV (intraventricular hemorrhage with parenchymal hemorrhage): OR = 3.826, 95% CI 1.612-9.083, p = 0.003.
Birth weight <2500 g: OR = 3.561, 95% CI 1.458-8.697, p = 0.005.
Perinatal asphyxia: OR = 3.294, 95% CI 1.347-8.053, p = 0.009.
Conclusions
The authors conclude that parenchymal hemorrhage, larger hemorrhage volume, low birth weight, and perinatal asphyxia are key determinants of neurodevelopmental disorders after neonatal ICH and recommend early intervention targeting these factors.
The study aimed to provide a reference for clinical intervention and prognostic improvement.
Early intervention strategies targeting these risk factors are proposed to enhance long-term prognosis.
What This Means
This study followed 80 babies who had bleeding inside the brain around the time of birth and were treated in a neonatal intensive care unit in Wenzhou, China. The children were assessed over 3 to 5 years using a standard developmental test (the Gesell Developmental Schedules), and doctors also checked for neurodevelopmental disorders using diagnostic criteria for Brain Damage Syndrome.
Development scores improved steadily over time, with average scores rising from about 72 at 1 year to about 87 at 5 years. Even so, by the end of follow-up about 44% of the children still had developmental scores below the study's cutoff, and about 39% met criteria for a neurodevelopmental disorder. The children most likely to have disorders were those whose bleeding extended into the brain tissue itself (including the most severe grade, Grade IV), those with birth weight under 2500 g, and those who experienced oxygen deprivation around birth (perinatal asphyxia).
This research suggests that many children recover partially but that a large share continue to have difficulties, and that certain features at birth may help identify children at higher risk who could benefit from closer monitoring and early support. The study was small and from a single center region, and it shows associations rather than proof of cause, so the findings should be interpreted with caution.
Lin S, Yu R, Ding Z, Lin Z. (2026). Neurodevelopmental Trajectories and Neurodevelopmental Disorders Following Neonatal Intracranial Hemorrhage: A Long-Term Follow-Up Study and Analysis of Influencing Factors.. Actas espanolas de psiquiatria. https://doi.org/10.62641/aep.2298