| Autor: |
Julia Epping, Theresa J. Rogers, Carl T. D'Angio, Nathalie L. Maitre, Marshall L. Summar, Erna Josiah-Davis, Maria Blanco, Jane O'Donnell, T.J. Mariani, Samantha Balan, Vasantha H.S. Kumar, Rita M. Ryan, Scarlett L. Bellamy, Dennis W. Nielson, Philip T. Levy, Melissa Fernando, Barbara Warner, David J. Durand, Shawna Rodgers, Steven Steele, Susan Kelley, Scott O Guthrie, Carmen Garcia, Anne Marie Reynolds, Karin L. Knowles, William D. Hardie, Jeffrey D. Merrill, Barbara Alexander, Timothy P. Stevens, Claudia Cleveland, Valerie Lunger, Julie A. Hoffmann, Karen M. McDowell, Donna Germuga, Elizabeth E. Rogers, Karen Martin, Jason Zayac, Laura Linneman, Gautam K. Singh, Kim Bordeaux, Deanna Maffet, Clement L. Ren, Lisa Flattery-Walsh, Stephanie D. Davis, Jack K. Sharp, Gina Simpson, Jonas H. Ellenberg, Aimee Horan, Lynn M. Taussig, Hart F. Horneman, Mark O'Hunt, Amy Beller, Elizabeth R. Werner, Charles Clem, Roberta A. Ballard, Thomas W. Ferkol, Katrina Burson, Jayne Sicard-Su, Tanya Scalise, Sarah Martin, Eileen Popplewell, M. Layne Lillie, Kim Ciccio, Shannon Castiglione, Carol J. Blaisdell, Lori Pacello, Philip L. Ballard, C. Michael Cotten, Brenda B. Poindexter, Tari Gratton, Sharon Wadley, Mary Jane Platt, Ann Tierney, Daniel K. Sperry, Kelly Thornton, Kristin Scheible, Roberta L. Keller, Pamela A. Shaw, Judith A. Voynow, Claire A. Chougnet, Kim Fisher, Georgia E. McDavid, Rick Hinojosa, Sandra Prentice, James M. Greenberg, Rui Feng, Jeanette M. Asselin, Barbara Schmidt, Pamela Bates, Susan Gunn, Denise Cifelli, Christopher Johnson, Howard B. Panitch, Cheryl J. Chapin, Heidie Huyck, Cathy Grisby, Tina V. Hartert, Amir M. Khan, Sara B. DeMauro, Lauren Jewett, Judy L. Aschner, Julie Arldt-McAlister, Aaron Hamvas, Leslie A. Lusk, James Kemp, Beth Koch, Pam Brown, Gloria S. Pryhuber, Candice D. Fike, Alan H. Jobe, Mark R. Holland, Michael G. Sacilowski, Odessa L. Settles, Nancy Jenks, Paul E. Moore, Eric C. Eichenwald |
| Rok vydání: |
2016 |
| Předmět: |
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| Zdroj: |
The Journal of pediatrics. 187 |
| ISSN: |
1097-6833 |
| Popis: |
To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs).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.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.Both bronchopulmonary dysplasia and perinatal clinical data accurately identify ELGANs at risk for persistent and severe respiratory morbidity at 1 year.ClinicalTrials.gov: NCT01435187. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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Full Text from ScienceDirect 