Association of inotrope use with neurodevelopmental outcomes in infants <29 weeks gestation: a retrospective cohort study
| Autor: | Edmond Kelly, Stefani M Doucette, Vibhuti Shah, Cnfun Investigators, Paige Church, Shoo K. Lee |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Inotrope
Canada Pediatrics medicine.medical_specialty Gestational Age Infant Newborn Diseases Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Enterocolitis Necrotizing Sepsis 030225 pediatrics medicine Humans Retinopathy of Prematurity Retrospective Studies Hearing Loss Mixed Conductive-Sensorineural Bronchopulmonary Dysplasia Cerebral Hemorrhage 030219 obstetrics & reproductive medicine business.industry Infant Newborn Infant Obstetrics and Gynecology Gestational age Retrospective cohort study Pediatrics Perinatology and Child Health Gestation Female Steroids business Infant Premature |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 35:6044-6052 |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.1080/14767058.2021.1904872 |
| Popis: | The primary objective was to compare neurodevelopmental (ND) outcomes at 18-24 months in preterm infants29 weeks gestational age (GA) who received versus those who did not receive inotropes in the first week of life. The secondary objective was to assess ND outcomes according to the duration of inotropic support in the first week of life (≤3 or3 days).Retrospective population-based cohort study of preterm infants29 weeks GA admitted to participating neonatal intensive care units (NICUs) of the Canadian Neonatal Network (CNN) from January 2010 to September 2011 with follow-up data available at 18-24 months. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III). Long-term outcomes were categorized as neurodevelopmental impairment (NDI) and significant neurodevelopmental impairment (sNDI), and effect modification due to other neonatal morbidities including receipt of antenatal steroids, GA, small for gestational age (SGA) status, sex, score for neonatal acute physiology (SNAP-II)20, postnatal steroids, bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) grade ≥3/periventricular leukomalacia (PVL), early- and late-onset sepsis, retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC) was assessed. Maternal and infant demographic characteristics and short- and long-term outcomes were compared using Pearson's Chi-square test for categorical variables and Student'sOf the 491 (18.7%) eligible preterm infants who received inotropes during the first week of life, 314 (64%) survived to NICU discharge and 245 (78%) had ND outcome data available. A total of 1775 eligible preterm infants did not receive inotropes in the first week of life; 1647 (92.7%) survived to NICU discharge and 1149 (70%) had ND outcome data. Maternal and infant characteristics associated with infants receiving inotropes included: younger maternal age, clinical chorioamnionitis, no antenatal steroids, outborn, lower GA, BW and Apgar scores at both one and five minutes; and higher SNAP-II scores (In this large, population-based cohort, infants who received inotropes in the first week of life were at increased risk for sensorineural or mixed hearing loss. There was no difference in NDI or sNDI after adjusting for confounding variables. A longer duration of inotrope use in the first week of life was associated with lower BSID-III cognitive and motor scores, but no difference in overall NDI or sNDI. |
| Databáze: | OpenAIRE |
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