The relationship of periventricular-intraventricular hemorrhage in infants of <32 weeks gestation to the occurrence of disability at 5 years of age was studied in a National Collaborative Survey in the Netherlands. Of 484 infants enrolled, all 304 survivors were examined at age 5 years; 26% of infants with severe hemorrhage and 67% with mild grades I/II survived the neonatal period. Of 85 (28%) survivors with a disability, 27 (9%) had a minor handicap and 23 (8%) a major handicap. The handicap was recorded at the age of 5 but was not present at 2 years in 17 children, while 35 were handicapped at 2 years but not at 5 years. Children with grades I and II as well as III and IV had more disabilities and handicaps than children without hemorrhage. [1]

COMMENT. The small number of survivors with grades III and IV hemorrhage was attributed to the widely used policy in the Netherlands of withdrawing life-support from infants with severe cerebral damage. Of 65 in this category, 47 died in the neonatal period. At the 5 year evaluation, only 25% of the patients had had severe hemorrhage. Children with only mild hemorrhage had a significantly increased risk of disability at the age of 5 years. Patients with evidence of periventricular leukomalacia were excluded from this study.