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Abstract Background: to determine the risk factors associated with intraventricular hemorrhage in preterm neonates with pneumothorax Methods: in this case control study 40 preterm neonates with pneumothorax with gestational age less than (36 weeks) were grouped into group A and B. group A patients Included 20 preterm neonates between 28-32 weeks gestation group B 20 preterm between 32-36 weeks gestation Brain Sonography was assessed at admission of all premature neonates to exclude any case with IVH and also assessed after developing pneumothorax to determinate neonates with IVH. Results: There was statistically significant difference between the two studied groups according to, age, weight, length, head circumference, and Cranial Ultrasound Study, mortality, diagnosis. There was statistically significant difference between normal group and IVH group according to birth weight, gestational age, head circumference, mortality, respiratory distress and, main arterial blood pressure. There was no statistically significant difference within the two groups as regard gender, delivery, main arterial blood pressure, Site of pneumothorax, Consanguity and Ventilation. Conclusion: Pneumothorax in preterm neonates was associated with increase occurrence and severity of Intraventricular Hemorrhage |