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Bronchopulmonary Dysplasia and Perinatal Characteristics Predict 1-Year Respiratory Outcomes in Newborns Born at Extremely Low Gestational Age: A Prospective Cohort Study
| Content Provider | Scilit |
|---|---|
| Author | O'Hunt, Mark D'Angio, Carl O'Donnell, Jane Keller, Roberta L. Feng, Rui DeMauro, Sara B. Ferkol, Thomas Hardie, William Rogers, Elizabeth E. Stevens, Timothy P. Voynow, Judith A. Bellamy, Scarlett L. Shaw, Pamela A. Moore, Paul E. Alexander, Barbara Chougnet, Claire Gratton, Tari Greenberg, James M. Grisby, Cathy Jobe, Alan H. Koch, Beth McDowell, Karen Thornton, Kelly Bates, Pamela Cleveland, Claudia Hamvas, Aaron Hoffmann, Julie Holland, Mark R. Kemp, James Levy, Philip T. Linneman, Laura Sicard-Su, Jayne Simpson, Gina Singh, Gautam K. Warner, Barbara Ballard, Philip L. Ballard, Roberta A. Durand, David J. Eichenwald, Eric C. Khan, Amir M. Lusk, Leslie Merrill, Jeffrey D. Nielson, Dennis W. Asselin, Jeanette M. Balan, Samantha Burson, Katrina Chapin, Cheryl Josiah-Davis, Erna Garcia, Carmen Horneman, Hart Hinojosa, Rick Johnson, Christopher Kelley, Susan Knowles, Karin L. Lillie, M. Layne Martin, Karen Martin, Sarah Arldt-McAlister, Julie McDavid, Georgia E. Pacello, Lori Rodgers, Shawna Sperry, Daniel K. Aschner, Judy Beller, Amy B. Fike, Candice Guthrie, Scott Hartert, Tina Maitre, Nathalie Rogers, Theresa J. Settles, Odessa L. Steele, Steven Summar, Marshall Wadley, Sharon Kumar, Vasanth Mariani, Tom Pryhuber, Gloria Ren, Clement Reynolds, Anne Marie Ryan, Rita M. Scheible, Kristin Huyck, Heidie Lunger, Valerie Castiglione, Shannon Horan, Aimee Maffet, Deanna Sacilowski, Michael Scalise, Tanya Werner, Elizabeth Zayac, Jason Bordeaux, Kim Brown, Pam Epping, Julia Flattery-Walsh, Lisa Germuga, Donna Jenks, Nancy Platt, Mary Popplewell, Eileen Prentice, Sandra Ciccio, Kim Cotten, C. Michael Fisher, Kim Sharp, Jack Clem, Charles Davis, Stephanie Gunn, Susan Jewett, Lauren Poindexter, Brenda Blanco, Maria Cifelli, Denise Ellenberg, Jonas Fernando, Melissa Panitch, Howard Schmidt, Barbara Tierney, Ann Taussig, Lynn M. Blaisdell, Carol J. |
| Copyright Year | 2017 |
| Description | Journal: The Journal of Pediatrics Objective To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs). Study design We enrolled ELGANs (<29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonatal clinical data through 36 weeks' postmenstrual age. We surveyed caregivers at 3, 6, 9, and 12 months' corrected age to identify postdischarge respiratory morbidity, defined as hospitalization, home support (oxygen, tracheostomy, ventilation), medications, or symptoms (cough/wheeze). Infants were classified as having postprematurity respiratory disease (PRD, the primary study outcome) if respiratory morbidity persisted over ≥2 questionnaires. Infants were classified with severe respiratory morbidity if there were multiple hospitalizations, exposure to systemic steroids or pulmonary vasodilators, home oxygen after 3 months or mechanical ventilation, or symptoms despite inhaled corticosteroids. Mixed-effects models generated with data available at 1 day (perinatal) and 36 weeks' postmenstrual age were assessed for predictive accuracy. Results Of 724 infants (918 ± 234 g, 26.7 ± 1.4 weeks' gestational age) classified for the primary outcome, 68.6% had PRD; 245 of 704 (34.8%) were classified as severe. Male sex, intrauterine growth restriction, maternal smoking, race/ethnicity, intubation at birth, and public insurance were retained in perinatal and 36-week models for both PRD and respiratory morbidity severity. The perinatal model accurately predicted PRD (c-statistic 0.858). Neither the 36-week model nor the addition of bronchopulmonary dysplasia to the perinatal model improved accuracy (0.856, 0.860); c-statistic for BPD alone was 0.907. Conclusion Both bronchopulmonary dysplasia and perinatal clinical data accurately identify ELGANs at risk for persistent and severe respiratory morbidity at 1 year. Trial registration ClinicalTrials.gov: NCT01435187. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533632/pdf http://www.jpeds.com/article/S0022347617305097/pdf |
| ISSN | 00223476 |
| e-ISSN | 10976833 |
| DOI | 10.1016/j.jpeds.2017.04.026 |
| Journal | The Journal of Pediatrics |
| Volume Number | 187 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2017-05-17 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Journal of Pediatrics Pediatrics and Child Health Pulmonary Morbidity Bronchopulmonary Dysplasia Extremely Low Gestational Age Newborn Postmenstrual Age Postprematurity Respiratory Disease Prematurity and Respiratory Outcomes Program Respiratory Morbidity Severity |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pediatrics, Perinatology and Child Health |
