TY - JOUR
T1 - Early-life respiratory trajectories and neurodevelopmental outcomes in infants born very and extremely preterm
T2 - A retrospective study
AU - Yu, Wen Hao
AU - Chu, Chi Hsiang
AU - Lin, Yung Chieh
AU - Chen, Ray Bing
AU - Iwata, Osuke
AU - Huang, Chao Ching
N1 - Funding Information:
The authors thank Chien‐Jung Ho and Ting‐Jyun Jhuo at the Preterm Research Center of National Cheng Kung University and Yzu‐Yu Liu from the Taiwan Premature Baby Foundation for data collection and follow‐up assessment of children born preterm. None of these individuals were compensated for their contributions. This study was supported by grants from the Taiwan Ministry of Science and Technology (nos. MOST 110‐2314‐B‐006‐113 and MOST 110‐2314‐B‐006‐057) and from the National Cheng Kung University Hospital (no. NCKUH‐11001002).
Funding Information:
The authors thank Chien-Jung Ho and Ting-Jyun Jhuo at the Preterm Research Center of National Cheng Kung University and Yzu-Yu Liu from the Taiwan Premature Baby Foundation for data collection and follow-up assessment of children born preterm. None of these individuals were compensated for their contributions. This study was supported by grants from the Taiwan Ministry of Science and Technology (nos. MOST 110-2314-B-006-113 and MOST 110-2314-B-006-057) and from the National Cheng Kung University Hospital (no. NCKUH-11001002).
Publisher Copyright:
© 2022 Mac Keith Press.
PY - 2022/10
Y1 - 2022/10
N2 - Aim: To determine whether early-life respiratory trajectories are associated with neurodevelopmental impairment (NDI) in infants born very and extremely preterm. Method: The daily type of respiratory supports in the first 8 weeks after birth were analysed in 546 infants (285 males, 261 females; median gestational age = 28.0 weeks, interquartile range = 3 weeks), comprising 301 infants born very preterm (gestation = 28–30 weeks) and 245 infants born extremely preterm (gestation <28 weeks), who survived to discharge from 2004 to 2018 and received follow-up assessment by Bayley Scales of Infant and Toddler Development at a corrected age of 24 months. NDI included cognition or motor impairment, moderate and severe cerebral palsy, or visual and hearing impairment. Results: Clustering analysis identified three respiratory patterns with increasing severity: improving; slowly improving; and delayed improvement. These were significantly associated with increasing rates of NDI in infants born very and extremely preterm and smaller head circumference in infants born extremely preterm (both p < 0.001). By day 28, the proportion of infants who were under different categories of ventilation support significantly differed according to the three trajectory groups in infants born very and extremely preterm (both p < 0.05). Models that included adverse respiratory trajectories demonstrated more negative impacts on neurodevelopment than those without. Interpretation: An adverse early-life respiratory trajectory was associated with NDI at follow-up, especially in infants born extremely preterm, suggesting a lung–brain axis of preterm birth. What this paper adds: Clustering analysis identified three respiratory trajectories with increasing severity in infants born preterm. Increasing severity of respiratory trajectories was associated with increasing rates of neurodevelopmental impairment. Adverse respiratory trajectories had a significantly negative impact on neurodevelopmental outcomes.
AB - Aim: To determine whether early-life respiratory trajectories are associated with neurodevelopmental impairment (NDI) in infants born very and extremely preterm. Method: The daily type of respiratory supports in the first 8 weeks after birth were analysed in 546 infants (285 males, 261 females; median gestational age = 28.0 weeks, interquartile range = 3 weeks), comprising 301 infants born very preterm (gestation = 28–30 weeks) and 245 infants born extremely preterm (gestation <28 weeks), who survived to discharge from 2004 to 2018 and received follow-up assessment by Bayley Scales of Infant and Toddler Development at a corrected age of 24 months. NDI included cognition or motor impairment, moderate and severe cerebral palsy, or visual and hearing impairment. Results: Clustering analysis identified three respiratory patterns with increasing severity: improving; slowly improving; and delayed improvement. These were significantly associated with increasing rates of NDI in infants born very and extremely preterm and smaller head circumference in infants born extremely preterm (both p < 0.001). By day 28, the proportion of infants who were under different categories of ventilation support significantly differed according to the three trajectory groups in infants born very and extremely preterm (both p < 0.05). Models that included adverse respiratory trajectories demonstrated more negative impacts on neurodevelopment than those without. Interpretation: An adverse early-life respiratory trajectory was associated with NDI at follow-up, especially in infants born extremely preterm, suggesting a lung–brain axis of preterm birth. What this paper adds: Clustering analysis identified three respiratory trajectories with increasing severity in infants born preterm. Increasing severity of respiratory trajectories was associated with increasing rates of neurodevelopmental impairment. Adverse respiratory trajectories had a significantly negative impact on neurodevelopmental outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85127496566&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85127496566&partnerID=8YFLogxK
U2 - 10.1111/dmcn.15234
DO - 10.1111/dmcn.15234
M3 - Article
C2 - 35383902
AN - SCOPUS:85127496566
SN - 0012-1622
VL - 64
SP - 1246
EP - 1253
JO - Developmental Medicine and Child Neurology
JF - Developmental Medicine and Child Neurology
IS - 10
ER -