Dataset Information

The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants.

ABSTRACT:

Background

This study aims to determine the association between clinical patterns of early respiratory disease and diastolic dysfunction in preterm infants.

Methods

Preterm infants <29 weeks' gestation underwent cardiac ultrasounds around day 7 and 14-21. Respiratory dysfunction patterns were classified as stable (ST), respiratory deterioration (RD) or early persistent respiratory dysfunction (EPRD) according to oxygen need. Diastolic dysfunction was diagnosed using a multi-parameter approach including left atrial strain (LAS_R) to help differentiate between cardiac or pulmonary pathophysiology.

Results

98 infants (mean 27 weeks) were included. The prevalence of ST, RD and EPRD was 53%, 21% and 26% respectively. Diastolic dysfunction was more prevalent in the RD and EPRD groups with patent ductus arteriosus and significant growth restriction as risk factors. Not all infants with a PDA developed diastolic dysfunction. LAS_R was lower in the EPDR group.

Conclusion

Respiratory dysfunction patterns are associated with diastolic dysfunction in preterm infants.

SUBMITTER: de Waal K

PROVIDER: S-EPMC10541326 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants.

de Waal Koert K Crendal Edward E Poon Amy Chin-Yu AC Latheef Mariyam Shaya MS Sachawars Elias E MacDougall Thomas T Phad Nilkant N

Journal of perinatology : official journal of the California Perinatal Association 20230223 10

<h4>Background</h4>This study aims to determine the association between clinical patterns of early respiratory disease and diastolic dysfunction in preterm infants.<h4>Methods</h4>Preterm infants <29 weeks' gestation underwent cardiac ultrasounds around day 7 and 14-21. Respiratory dysfunction patterns were classified as stable (ST), respiratory deterioration (RD) or early persistent respiratory dysfunction (EPRD) according to oxygen need. Diastolic dysfunction was diagnosed using a multi-parame ...[more]

PMID: 36823313

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Project description:Importance:It is unknown whether the age threshold (≤24 months) for preterm infants with chronic lung disease (CLD) to receive immunoprophylaxis for respiratory syncytial virus (RSV) as currently recommended by American Academy of Pediatrics guidelines correctly identified infants at higher risk for hospitalization for RSV. Objective:To determine the age when the risk of hospitalization for RSV among preterm infants with CLD becomes equivalent to the risk for healthy, 1-month-old term infants who do not qualify for immunoprophylaxis. Design, Setting, and Participants:A retrospective cohort study was conducted of 1 018 593 healthy term infants and 5181 preterm infants with CLD using Medicaid billing records (Medicaid Analytic eXtract files) from January 1, 1999, to December 31, 2010, linked to Florida and Texas birth and death certificates. Exposures:Age-trend discrete time logistic regression models within a survival analysis framework were developed, adjusting for covariates including the use of immunoprophylaxis, to compare the risk of hospitalization of preterm infants (<32 weeks' gestational age) with CLD at 3 through 34 months of age with the risk of hospitalization of term infants (37-41 weeks' gestational age) at 1 month of age. Main Outcomes and Measures:Age at which risk of hospitalization for RSV among preterm infants with CLD equals the risk for healthy term infants at age 1 month. Results:The study cohort included 1 018 593 healthy term infants and 5181 preterm infants with CLD; because patients could reenter the cohort for a second or third season, the total study cohort consisted of 1 880 531 healthy term infant-seasons (926 206 girls and 954 325 boys; mean [SD] age at first season entry, 12.6 [9.6] months) and 8680 CLD infant-seasons (3519 girls and 5161 boys; mean [SD] age at first season entry, 15.1 [9.1] months). Among term infants with siblings, the risk of hospitalization for RSV averaged across all covariate strata was 9.0 (95% CI, 8.4-9.6) per 1000 patient season-months at 1 month of age. The risk of hospitalization for RSV among preterm infants with CLD became similar to that of 1-month-old term infants at an age of 18.5 months (95% CI, 15.6-22.8). Conclusions and Relevance:The age threshold at which the risk of hospitalization for RSV among qualifying preterm infants with CLD approximates that of healthy term infants supports the current American Academy of Pediatrics practice guideline recommending RSV prophylaxis until a maximum of 24 months of age.

Dataset Information

The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants.

Background

Methods

Results

Conclusion

Publications

The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants.

Similar Datasets

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