Abstract Objective: Periventricular-intraventricular hemorrhage is the most common type of intracranial bleeding in newborns, especially in the first 3 days after birth. Severe periventricular-intraventricular hemorrhage is considered a progression from mild periventricular-intraventricular hemorrhage and is often closely associated with severe neurological sequelae. However, no specific indicators are available to predict the progression from mild to severe periventricular-intraventricular in early admission. This study aims to establish an early diagnostic prediction model for severe PIVH. Method: This study was a retrospective cohort study with data collected from the MIMIC-III (v1.4) database. Laboratory and clinical data collected within the first 24 h of NICU admission have been used as variables for both univariate and multivariate logistic regression analyses to construct a nomogram-based early prediction model for severe periventricular-intraventricular hemorrhage and subsequently validated. Results: A predictive model was established and represented by a nomogram, it comprised three variables: output, lowest platelet count and use of vasoactive drugs within 24 h of NICU admission. The model’s predictive performance showed by the calculated area under the curve was 0.792, indicating good discriminatory power. The calibration plot demonstrated good calibration between observed and predicted outcomes, and the Hosmer-Lemeshow test showed high consistency (p = 0.990). Internal validation showed the calculated area under a curve of 0.788. Conclusions: This severe PIVH predictive model, established by three easily obtainable indicators within the NICU, demonstrated good predictive ability. It offered a more user-friendly and convenient option for neonatologists. Objective Periventricularintraventricular Periventricular intraventricular newborns birth periventricularintraventricular periventricular sequelae However Method MIMICIII MIMIC III v1.4 v14 v v1 4 (v1.4 database 2 nomogrambased nomogram based validated Results output models s 0792 0 792 0.792 power outcomes HosmerLemeshow Hosmer Lemeshow p 0.990. 0990 0.990 . 990 0.990) 0788 788 0.788 Conclusions ability userfriendly user friendly neonatologists v1. (v1. 079 79 0.79 099 0.99 99 078 78 0.78 (v1 07 7 0.7 09 0.9 9 (v 0.