Association between mechanical ventilation and neurodevelopmental disorders in a nationwide cohort of extremely low birth weight infants

Wen Hui Tsai, Yea-Shwu Hwang, Te Yu Hung, Shih Feng Weng, Shio Jean Lin, Wen-Tsan Chang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Mechanical ventilation for preterm infants independently contributes to poor neurodevelopmental performance. However, few studies have investigated the association between the duration of mechanical ventilation and the risk for various developmental disorders in extremely low birth weight (ELBW) (<1000. g) infants. Using a large nationwide database, we did a 10-year retrospective follow-up study to explore the effect of mechanical ventilation on the incidence of cerebral palsy (CP), autism spectrum disorder (ASD), intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD) in ELBW infants born between 1998 and 2001. Seven hundred twenty-eight ELBW infants without diagnoses of brain insults or focal brain lesions in the initial hospital stay were identified and divided into three groups (days on ventilator: ≦2, 3-14, ≧15 days). After adjusting for demographic and medical factors, the infants in the ≧15 days group had higher risks for CP (adjusted hazard ratio: 2.66; 95% confidence interval: 1.50-4.59; p< 0.001) and ADHD (adjusted hazard ratio: 1.95; 95% confidence interval: 1.02-3.76; p< 0.05), than did infants in the ≦2 days group. The risk for ASD or ID was not significantly different between the three groups. We conclude that mechanical ventilation for ≧15 days increased the risk for CP and ADHD in ELBW infants even without significant neonatal brain damage. Developing a brain-protective respiratory support strategy in response to real-time cerebral hemodynamic and oxygenation changes has the potential to improve neurodevelopmental outcomes in ELBW infants.

Original languageEnglish
Pages (from-to)1544-1550
Number of pages7
JournalResearch in Developmental Disabilities
Volume35
Issue number7
DOIs
Publication statusPublished - 2014 Jan 1

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Extremely Low Birth Weight Infant
Artificial Respiration
Cerebral Palsy
Attention Deficit Disorder with Hyperactivity
Brain
Intellectual Disability
Confidence Intervals
Low Birth Weight Infant
Mechanical Ventilators
Premature Infants
Length of Stay
Hemodynamics
Demography
Databases
Neurodevelopmental Disorders
Incidence
Autism Spectrum Disorder

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Clinical Psychology

Cite this

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abstract = "Mechanical ventilation for preterm infants independently contributes to poor neurodevelopmental performance. However, few studies have investigated the association between the duration of mechanical ventilation and the risk for various developmental disorders in extremely low birth weight (ELBW) (<1000. g) infants. Using a large nationwide database, we did a 10-year retrospective follow-up study to explore the effect of mechanical ventilation on the incidence of cerebral palsy (CP), autism spectrum disorder (ASD), intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD) in ELBW infants born between 1998 and 2001. Seven hundred twenty-eight ELBW infants without diagnoses of brain insults or focal brain lesions in the initial hospital stay were identified and divided into three groups (days on ventilator: ≦2, 3-14, ≧15 days). After adjusting for demographic and medical factors, the infants in the ≧15 days group had higher risks for CP (adjusted hazard ratio: 2.66; 95{\%} confidence interval: 1.50-4.59; p< 0.001) and ADHD (adjusted hazard ratio: 1.95; 95{\%} confidence interval: 1.02-3.76; p< 0.05), than did infants in the ≦2 days group. The risk for ASD or ID was not significantly different between the three groups. We conclude that mechanical ventilation for ≧15 days increased the risk for CP and ADHD in ELBW infants even without significant neonatal brain damage. Developing a brain-protective respiratory support strategy in response to real-time cerebral hemodynamic and oxygenation changes has the potential to improve neurodevelopmental outcomes in ELBW infants.",
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Association between mechanical ventilation and neurodevelopmental disorders in a nationwide cohort of extremely low birth weight infants. / Tsai, Wen Hui; Hwang, Yea-Shwu; Hung, Te Yu; Weng, Shih Feng; Lin, Shio Jean; Chang, Wen-Tsan.

In: Research in Developmental Disabilities, Vol. 35, No. 7, 01.01.2014, p. 1544-1550.

Research output: Contribution to journalArticle

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AU - Chang, Wen-Tsan

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