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Journal article
Bronchopulmonary Dysplasia and Perinatal Characteristics Predict 1-Year Respiratory Outcomes in Newborns Born at Extremely Low Gestational Age: A Prospective Cohort Study
The Journal of pediatrics, v 187, pp 89-97
Aug 2017
PMID: 28528221
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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Details
- Title
- Bronchopulmonary Dysplasia and Perinatal Characteristics Predict 1-Year Respiratory Outcomes in Newborns Born at Extremely Low Gestational Age: A Prospective Cohort Study
- Creators
- Roberta L. Keller - University of California, San FranciscoRui Feng - University of PennsylvaniaSara B. DeMauro - University of PennsylvaniaThomas Ferkol - Departments of Pediatrics and Cell Biology and Physiology, Washington University, St Louis, MOWilliam Hardie - Cincinnati Children's Hospital Medical CenterElizabeth E. Rogers - University of California, San FranciscoTimothy P. Stevens - University of RochesterJudith A. Voynow - Virginia Commonwealth UniversityScarlett L. Bellamy - University of PennsylvaniaPamela A. Shaw - University of PennsylvaniaPaul E. Moore - Vanderbilt UniversityBarbara Alexander - Cincinnati Children's Hospital Medical CenterClaire Chougnet - Cincinnati Children's Hospital Medical CenterTari Gratton - Cincinnati Children's Hospital Medical CenterJames M. Greenberg - Cincinnati Children's Hospital Medical CenterCathy Grisby - Cincinnati Children's Hospital Medical CenterAlan H. Jobe - Cincinnati Children's Hospital Medical CenterBeth Koch - Cincinnati Children's Hospital Medical CenterKaren McDowell - Cincinnati Children's Hospital Medical CenterKelly Thornton - Cincinnati Children's Hospital Medical CenterPamela Bates - University of WashingtonClaudia Cleveland - University of WashingtonAaron Hamvas - University of WashingtonJulie Hoffmann - University of WashingtonMark R. Holland - University of WashingtonJames Kemp - University of WashingtonPhilip T. Levy - University of WashingtonLaura Linneman - University of WashingtonJayne Sicard-Su - University of WashingtonGina Simpson - University of WashingtonGautam K. Singh - University of WashingtonBarbara Warner - University of WashingtonPhilip L. Ballard - University of California, San FranciscoRoberta A. Ballard - University of California, San FranciscoDavid J. Durand - University of California, San FranciscoEric C. Eichenwald - University of California, San FranciscoAmir M. Khan - University of California, San FranciscoLeslie Lusk - University of California, San FranciscoJeffrey D. Merrill - University of California, San FranciscoDennis W. Nielson - University of California, San FranciscoJeanette M. Asselin - University of California, San FranciscoSamantha Balan - University of California, San FranciscoKatrina Burson - University of California, San FranciscoCheryl Chapin - University of California, San FranciscoErna Josiah-Davis - University of California, San FranciscoCarmen Garcia - University of California, San FranciscoHart Horneman - University of California, San FranciscoRick Hinojosa - University of California, San FranciscoChristopher Johnson - University of California, San FranciscoSusan Kelley - University of California, San FranciscoKarin L. Knowles - University of California, San FranciscoM. Layne Lillie - University of California, San FranciscoKaren Martin - University of California, San FranciscoSarah Martin - University of California, San FranciscoJulie Arldt-McAlister - University of California, San FranciscoGeorgia E. McDavid - University of California, San FranciscoLori Pacello - University of California, San FranciscoShawna Rodgers - University of California, San FranciscoDaniel K. Sperry - University of California, San FranciscoJudy Aschner - Vanderbilt UniversityAmy B Beller - Vanderbilt UniversityCandice Fike - Vanderbilt UniversityScott Guthrie - Vanderbilt UniversityTina Hartert - Vanderbilt UniversityNathalie Maitre - Vanderbilt UniversityMark O'Hunt - Vanderbilt UniversityTheresa J. Rogers - Vanderbilt UniversityOdessa L. Settles - Vanderbilt UniversitySteven Steele - Vanderbilt UniversityMarshall Summar - Vanderbilt UniversitySharon Wadley - Vanderbilt UniversityCarl D'Angio - University of RochesterVasanth Kumar - University of Rochester-BuffaloTom Mariani - University of RochesterGloria Pryhuber - University of RochesterClement Ren - University of RochesterAnne Marie Reynolds - University of RochesterRita M. Ryan - University of RochesterKristin Scheible - University of RochesterHeidie Huyck - University of RochesterValerie Lunger - University of RochesterShannon Castiglione - University of RochesterAimee Horan - University of RochesterDeanna Maffet - University of RochesterJane O'Donnell - University of RochesterMichael Sacilowski - University of RochesterTanya Scalise - University of RochesterElizabeth Werner - University of RochesterJason Zayac - University of RochesterKim Bordeaux - University of RochesterPam Brown - University of RochesterJulia Epping - University of RochesterLisa Flattery-Walsh - University of RochesterDonna Germuga - University of RochesterNancy Jenks - University of RochesterMary Platt - University of RochesterEileen Popplewell - University of RochesterSandra Prentice - University of RochesterKim Ciccio - Duke UniversityC. Michael Cotten - Duke UniversityKim Fisher - Duke UniversityJack Sharp - Duke UniversityCharles Clem - Duke UniversityStephanie Davis - Duke UniversitySusan Gunn - Duke UniversityLauren Jewett - Duke UniversityBrenda Poindexter - Duke UniversityMaria Blanco - University of PennsylvaniaDenise Cifelli - University of PennsylvaniaJonas Ellenberg - University of PennsylvaniaMelissa Fernando - University of PennsylvaniaHoward Panitch - University of PennsylvaniaBarbara Schmidt - University of PennsylvaniaAnn Tierney - University of PennsylvaniaLynn M. Taussig - University of DenverCarol J. Blaisdell - National Institutes of HealthPrematurity and Respiratory Outcomes Program
- Publication Details
- The Journal of pediatrics, v 187, pp 89-97
- Publisher
- Elsevier
- Grant note
- U01 HL101456; U01 HL101798; U01 HL101813; U01 HL101465; U01 HL 101800; R01 HL105702; U01 HL101794 / National Heart, Lung, and Blood Institute (http://dx.doi.org/10.13039/100000050)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000408221700019
- Scopus ID
- 2-s2.0-85020088554
- Other Identifier
- 991019299108604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics