AI Article Synopsis
- The study aimed to see if neonatal complications were linked to death or severe neurodevelopmental impairment in extremely preterm infants who lived to 36 weeks.
- It analyzed data from nearly 3,800 infants born between 22 and 26 weeks gestation at 15 research centers, finding that serious brain injury, bronchopulmonary dysplasia, and severe retinopathy were the most significant risks.
- A higher count of these morbidities correlated with increased rates of death or severe neurodevelopmental impairment, with rates jumping from 12.6% for no morbidities to 69.9% for all three.
Article Abstract
Objective: To determine if number of neonatal morbidities is associated with death or severe neurodevelopmental impairment (sNDI) among infants born extremely preterm who survived to 36 weeks' postmenstrual age (PMA).
Study Design: This is a retrospective cohort analysis of prospectively collected data from 15 NICHD Neonatal Research Network centers. Neonatal morbidities and 2-year outcomes were examined for 3794 infants born at 22 to 26 weeks' gestation from 2014 through 2019 who survived to 36 weeks' PMA.
Results: Serious brain injury (SBI), bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity (ROP) had the strongest bivariate associations with death or sNDI (ORs, 95% CI): 3.96 (3.39, 4.64), 3.41 (2.94, 3.95), and 2.66 (2.28, 3.11)], respectively. A morbidity count variable was constructed using these morbidities. The estimated ORs and 95% CI for death or sNDI with any 1, any 2, or all 3 of these morbidities, adjusted for maternal and infant characteristics and hospital of birth, increased from 2.75 (2.25, 3.37) to 6.10 (4.83, 7.70) to 12.90 (9.07, 18.36), respectively. Corresponding rates of late death or sNDI with none, any 1, any 2, and all 3 morbidities were 12.6%, 30.3%, 51.9%, and 69.9%, respectively. The estimated logistic model produced predictions of death or sNDI with moderate discrimination (C-statistic [95% CI]: 0.765 [0.749, 0.782]) and good calibration (Intercept [CITL] = -0.004, slope = 1.026).
Conclusions: Among infants born extremely preterm who survived to 36 weeks' PMA, a count of SBI, BPD, and severe ROP predicts death or sNDI.
Trial Registration: ClinicalTrials.gov ID Generic Database: NCT00063063.
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| http://dx.doi.org/10.1016/j.jpeds.2024.114428 | DOI Listing |
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