TY - JOUR
T1 - Chronic lung disease in full-term infants
T2 - Characteristics and neonatal intensive care outcomes in infants referred to children's hospitals
AU - Children's Hospitals Neonatal Consortium (CHNC) Severe BPD Focus Group
AU - Mikhael, Michel
AU - Cleary, John P.
AU - Zaniletti, Isabella
AU - Truog, William E.
AU - Ibrahim, John
AU - DiGeronimo, Robert
AU - Cuna, Alain
AU - Kielt, Matthew J.
AU - Coghill, Carl H.
AU - Vyas-Read, Shilpa
AU - Yallapragada, Sushmita
AU - Engle, William A.
AU - Savani, Rashmin C.
AU - Murthy, Karna
AU - Lagatta, Joanne M.
N1 - Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022
Y1 - 2022
N2 - Objective: To describe characteristics, outcomes, and risk factors for death or tracheostomy with home mechanical ventilation in full-term infants with chronic lung disease (CLD) admitted to regional neonatal intensive care units. Study Design: This was a multicenter, retrospective cohort study of infants born ≥37 weeks of gestation in the Children's Hospitals Neonatal Consortium. Results: Out of 67,367 full-term infants admitted in 2010–2016, 4886 (7%) had CLD based on receiving respiratory support at either 28 days of life or discharge. 3286 (67%) were still hospitalized at 28 days receiving respiratory support, with higher mortality risk than those without CLD (10% vs. 2%, p < 0.001). A higher proportion received tracheostomy (13% vs. 0.3% vs. 0.4%, p < 0.001) and gastrostomy (30% vs. 1.7% vs. 3.7%, p < 0.001) compared to infants with CLD discharged home before 28 days and infants without CLD, respectively. The diagnoses and surgical procedures differed significantly between the two CLD subgroups. Small for gestational age, congenital pulmonary, airway, and cardiac anomalies and bloodstream infections were more common among infants with CLD who died or required tracheostomy with home ventilation (p < 0.001). Invasive ventilation at 28 days was independently associated with death or tracheostomy and home mechanical ventilation (odds ratio 7.6, 95% confidence interval 5.9–9.6, p < 0.0001). Conclusion: Full-term infants with CLD are at increased risk for morbidity and mortality. We propose a severity-based classification for CLD in full-term infants. Future work to validate this classification and its association with early childhood outcomes is necessary.
AB - Objective: To describe characteristics, outcomes, and risk factors for death or tracheostomy with home mechanical ventilation in full-term infants with chronic lung disease (CLD) admitted to regional neonatal intensive care units. Study Design: This was a multicenter, retrospective cohort study of infants born ≥37 weeks of gestation in the Children's Hospitals Neonatal Consortium. Results: Out of 67,367 full-term infants admitted in 2010–2016, 4886 (7%) had CLD based on receiving respiratory support at either 28 days of life or discharge. 3286 (67%) were still hospitalized at 28 days receiving respiratory support, with higher mortality risk than those without CLD (10% vs. 2%, p < 0.001). A higher proportion received tracheostomy (13% vs. 0.3% vs. 0.4%, p < 0.001) and gastrostomy (30% vs. 1.7% vs. 3.7%, p < 0.001) compared to infants with CLD discharged home before 28 days and infants without CLD, respectively. The diagnoses and surgical procedures differed significantly between the two CLD subgroups. Small for gestational age, congenital pulmonary, airway, and cardiac anomalies and bloodstream infections were more common among infants with CLD who died or required tracheostomy with home ventilation (p < 0.001). Invasive ventilation at 28 days was independently associated with death or tracheostomy and home mechanical ventilation (odds ratio 7.6, 95% confidence interval 5.9–9.6, p < 0.0001). Conclusion: Full-term infants with CLD are at increased risk for morbidity and mortality. We propose a severity-based classification for CLD in full-term infants. Future work to validate this classification and its association with early childhood outcomes is necessary.
KW - Children's Hospitals Neonatal Consortium
KW - chronic lung disease
KW - full-term
UR - http://www.scopus.com/inward/record.url?scp=85133902781&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85133902781&partnerID=8YFLogxK
U2 - 10.1002/ppul.25983
DO - 10.1002/ppul.25983
M3 - Article
C2 - 35578392
AN - SCOPUS:85133902781
SN - 8755-6863
JO - Pediatric pulmonology
JF - Pediatric pulmonology
ER -