RTI uses cookies to offer you the best experience online. By clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.
Association of a count of inpatient morbidities with two-year outcomes among infants born extremely preterm
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2024). Association of a count of inpatient morbidities with two-year outcomes among infants born extremely preterm. The Journal of Pediatrics, 114428. Advance online publication. https://doi.org/10.1016/j.jpeds.2024.114428
OBJECTIVE: To determine if number of neonatal morbidities is associated with death or severe neurodevelopmental impairment (sNDI) among infants born extremely preterm who survived to 36 weeks' postmenstrual age (PMA).
STUDY DESIGN: This is a retrospective cohort analysis of prospectively collected data from 15 NICHD Neonatal Research Network (NRN) centers. Neonatal morbidities and 2-year outcomes were examined for 3794 infants born at 22 to 26 weeks' gestation from 2014 through 2019 who survived to 36 weeks' PMA.
RESULTS: Serious brain injury (SBI), bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity (ROP) had the strongest bivariate associations with death or sNDI: odds ratios (ORs, 95% confidence Interval [CI] )3.96 (3.39 , 4.64), 3.41 (2.94 , 3.95), and 2.66 (2.28 , 3.11), respectively. A morbidity count variable was constructed using these morbidities. The estimated (ORs and 95% CI for death or sNDI with any 1, any 2, or all 3 of these morbidities, adjusted for maternal and infant characteristics and hospital of birth, increased from 2.75 (2.25, 3.37) to 6.10 (4.83, 7.70) to 12.90 (9.07, 18.36), respectively. Corresponding rates of late death or sNDI with none, any 1, any 2, and all 3 morbidities were 12.6%, 30.3%, 51.9%, and 69.9%, respectively. The estimated logistic model produced predictions of death or sNDI with moderate discrimination (C-statistic [95% CI]: 0.765 [0.749, 0.782]) and good calibration (Intercept[CITL]= -0.004, slope=1.026).
CONCLUSIONS: Among infants born extremely preterm who survived to 36 weeks' PMA, a count of SBI, BPD, and severe ROP predicts death or sNDI.
