Document Detail


Chronic oxygen dependency in infants born at 24-32 weeks' gestation: the role of antenatal and neonatal factors.
MedLine Citation:
PMID:  9401883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study the incidence of chronic oxygen dependency (COD) among ventilated survivors born at 24-32 weeks gestation from 1986 to 1994 and to identify antenatal and neonatal factors that may have changed with time; and to identify antenatal and neonatal factors that could contribute to the development of COD in infants born at 24-32 weeks gestation using a case control model. METHODOLOGY: Infants born at 24-32 weeks gestation in one tertiary referral centre between 1986 and 1994 and admitted to the neonatal intensive care unit for respiratory support were studied. Data accumulated prospectively since 1986 in survivors of ventilation were analyzed to identify antenatal and neonatal factors that could have changed with time. The cohort of infants who developed COD were matched for gestation and time of birth with a control group of infants who did not have COD. Significant factors that could have contributed to the development of COD were identified using forward logistic regression analysis. RESULTS: The number of mothers admitted for threatened premature labour (TPL), and pregnancy induced hypertension decreased with time while the use of antenatal steroids and maternal antibiotics increased. More infants were delivered by Caesarean section during the later years. There was an increase in neonatal septicaemia with time while there were decreases in hyaline membrane disease, pneumothorax, pulmonary interstitial emphysema, use of high peak inspiratory pressure (PIP) and high inspired oxygen. The incidence of COD decreased. The case controlled study revealed a significant positive association between COD and male gender, birthweight less than the 10th percentile for gestation, PIP over 30 cm H2O, septicaemia and significant patent ductus arteriosus (PDA) requiring indomethacin. There was a negative association with TPL. CONCLUSIONS: Further decrease in COD can be achieved only if septicaemia, PDA and the use of high PIP can be avoided. The most effective way of reducing the incidence of COD is by reducing the incidence of prematurity.
Authors:
D A Todd; A Jana; E John
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  33     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1998-01-22     Completed Date:  1998-01-22     Revised Date:  2007-09-24    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  402-7     Citation Subset:  IM    
Affiliation:
Department of Neonatology, Westmead Hospital, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Apgar Score
Birth Weight
Bronchopulmonary Dysplasia / etiology*,  mortality,  therapy
Case-Control Studies
Chronic Disease
Female
Gestational Age
Health Status
Humans
Infant, Newborn
Infant, Premature*
Male
Obstetric Labor, Premature
Oxygen Inhalation Therapy*
Positive-Pressure Respiration / adverse effects
Pregnancy
Pregnancy Complications*
Respiration, Artificial / adverse effects
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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