Abstract
Background: The analysis of early patterns of lung disease among preterm infants may help to identify predictors of pulmonary deterioration. Objectives: To analyze FIO2 requirement in the first 14 days of life among preterm infants and to find predictors of bronchopulmonary dysplasia (BPD). Methods: Retrospective cohort study. Setting: 3 Italian level III NICUs. Population: Infants born between 240/7 and 276/7 weeks' gestational age (GA) who survived to 14 days. A consecutive sample of 588 infants was analyzed. Daily mode FIO2 in the first 2 weeks of life were analyzed according to the criteria defined by Laughon et al. [Pediatrics 2009;123:1124-1131], who found 3 early respiratory patterns: Consistently low FIO2 (LowFIO2), pulmonary deterioration (PD), and early persistent pulmonary deterioration (EPPD). Factors associated with pulmonary deterioration were studied by univariate and multivariate analysis. Results: Forty percent of infants had low FIO2, 18% had pulmonary deterioation, 21% had early persistent pulmonary deterioration, and 21% had a previously unreported pattern (pulmonary improvement, PI). The prevalence of BPD was 7% in the LowFIO2 group, 28% in the PI group, 44% in the PD group, and 62% in the EPPD group (p = 0.000). Infants with lung deterioration were more frequently males (OR = 2.019, CI: 1.319-3.090, p = 0.001), had lower GA (OR = 0.945, CI: 0.915-0.975, p = 0.000), higher incidence of severe respiratory distress syndrome (OR = 2.956, CI: 1.430-6.112, p = 0.003), and lack of postnatal caffeine (OR = 0.167, CI: 0.052-0.541, p = 0.003). Conclusions: We report 4 distinct patterns of early respiratory disease associated with significantly different prevalence of BPD and discuss risk factors for lung deterioration.
| Original language | English |
|---|---|
| Pages (from-to) | 53-59 |
| Number of pages | 7 |
| Journal | Neonatology |
| Volume | 112 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jun 1 2017 |
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Keywords
- Chronic lung disease
- Early respiratory disease
- Preterm infants
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Developmental Biology
Cite this
New Insights on Early Patterns of Respiratory Disease among Extremely Low Gestational Age Newborns. / Nobile, Stefano; Marchionni, Paolo; Vento, Giovanni; Vendettuoli, Valentina; Marabini, Claudio; Lio, Alessandra; Ricci, Cinzia; Mercadante, Domenica; Colnaghi, Mariarosa; Mosca, Fabio; Romagnoli, Costantino; Carnielli, Virgilio.
In: Neonatology, Vol. 112, No. 1, 01.06.2017, p. 53-59.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - New Insights on Early Patterns of Respiratory Disease among Extremely Low Gestational Age Newborns
AU - Nobile, Stefano
AU - Marchionni, Paolo
AU - Vento, Giovanni
AU - Vendettuoli, Valentina
AU - Marabini, Claudio
AU - Lio, Alessandra
AU - Ricci, Cinzia
AU - Mercadante, Domenica
AU - Colnaghi, Mariarosa
AU - Mosca, Fabio
AU - Romagnoli, Costantino
AU - Carnielli, Virgilio
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: The analysis of early patterns of lung disease among preterm infants may help to identify predictors of pulmonary deterioration. Objectives: To analyze FIO2 requirement in the first 14 days of life among preterm infants and to find predictors of bronchopulmonary dysplasia (BPD). Methods: Retrospective cohort study. Setting: 3 Italian level III NICUs. Population: Infants born between 240/7 and 276/7 weeks' gestational age (GA) who survived to 14 days. A consecutive sample of 588 infants was analyzed. Daily mode FIO2 in the first 2 weeks of life were analyzed according to the criteria defined by Laughon et al. [Pediatrics 2009;123:1124-1131], who found 3 early respiratory patterns: Consistently low FIO2 (LowFIO2), pulmonary deterioration (PD), and early persistent pulmonary deterioration (EPPD). Factors associated with pulmonary deterioration were studied by univariate and multivariate analysis. Results: Forty percent of infants had low FIO2, 18% had pulmonary deterioation, 21% had early persistent pulmonary deterioration, and 21% had a previously unreported pattern (pulmonary improvement, PI). The prevalence of BPD was 7% in the LowFIO2 group, 28% in the PI group, 44% in the PD group, and 62% in the EPPD group (p = 0.000). Infants with lung deterioration were more frequently males (OR = 2.019, CI: 1.319-3.090, p = 0.001), had lower GA (OR = 0.945, CI: 0.915-0.975, p = 0.000), higher incidence of severe respiratory distress syndrome (OR = 2.956, CI: 1.430-6.112, p = 0.003), and lack of postnatal caffeine (OR = 0.167, CI: 0.052-0.541, p = 0.003). Conclusions: We report 4 distinct patterns of early respiratory disease associated with significantly different prevalence of BPD and discuss risk factors for lung deterioration.
AB - Background: The analysis of early patterns of lung disease among preterm infants may help to identify predictors of pulmonary deterioration. Objectives: To analyze FIO2 requirement in the first 14 days of life among preterm infants and to find predictors of bronchopulmonary dysplasia (BPD). Methods: Retrospective cohort study. Setting: 3 Italian level III NICUs. Population: Infants born between 240/7 and 276/7 weeks' gestational age (GA) who survived to 14 days. A consecutive sample of 588 infants was analyzed. Daily mode FIO2 in the first 2 weeks of life were analyzed according to the criteria defined by Laughon et al. [Pediatrics 2009;123:1124-1131], who found 3 early respiratory patterns: Consistently low FIO2 (LowFIO2), pulmonary deterioration (PD), and early persistent pulmonary deterioration (EPPD). Factors associated with pulmonary deterioration were studied by univariate and multivariate analysis. Results: Forty percent of infants had low FIO2, 18% had pulmonary deterioation, 21% had early persistent pulmonary deterioration, and 21% had a previously unreported pattern (pulmonary improvement, PI). The prevalence of BPD was 7% in the LowFIO2 group, 28% in the PI group, 44% in the PD group, and 62% in the EPPD group (p = 0.000). Infants with lung deterioration were more frequently males (OR = 2.019, CI: 1.319-3.090, p = 0.001), had lower GA (OR = 0.945, CI: 0.915-0.975, p = 0.000), higher incidence of severe respiratory distress syndrome (OR = 2.956, CI: 1.430-6.112, p = 0.003), and lack of postnatal caffeine (OR = 0.167, CI: 0.052-0.541, p = 0.003). Conclusions: We report 4 distinct patterns of early respiratory disease associated with significantly different prevalence of BPD and discuss risk factors for lung deterioration.
KW - Chronic lung disease
KW - Early respiratory disease
KW - Preterm infants
UR - http://www.scopus.com/inward/record.url?scp=85015921336&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85015921336&partnerID=8YFLogxK
U2 - 10.1159/000456706
DO - 10.1159/000456706
M3 - Article
AN - SCOPUS:85015921336
VL - 112
SP - 53
EP - 59
JO - Neonatology
JF - Neonatology
SN - 1661-7800
IS - 1
ER -