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Follow up of premature babies treated with artificial surfactant (ALEC)
1Department of Paediatrics, Addenbrooke's Hospital, Cambridge.
Insights
Artificial surfactant treatment improved survival for premature infants without increasing neurodevelopmental impairment. This study followed 231 infants, finding no significant differences in long-term health outcomes between treated and control groups.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Clinical Trials
Background:
- Premature infants face significant risks, including respiratory distress syndrome.
- Artificial surfactant administration is a key intervention for improving survival in preterm neonates.
- Long-term neurodevelopmental outcomes following surfactant treatment require continued investigation.
Purpose of the Study:
- To assess the long-term neurodevelopmental and health outcomes of infants treated with artificial surfactant.
- To determine if improved neonatal survival from surfactant therapy is associated with increased neurodevelopmental impairment.
- To compare outcomes up to 18 months in infants born before 30 weeks' gestation who received surfactant.
Main Methods:
- A randomized trial involving 235 preterm survivors.
- Follow-up data collected at 9 and 18 months for 212 infants, and at 9 months for 7 infants.
- Outcomes assessed included neurological and mental impairment, respiratory infections, allergies, and hospital admissions.
Main Results:
- No significant differences were observed in neurological impairment, mental impairment, respiratory infections, allergies, or hospital admissions between surfactant-treated and control groups up to 18 months.
- In infants born before 30 weeks' gestation, 57% of the surfactant-treated group were normal compared to 41% in the control group.
- Improved survival rates in the surfactant group were not linked to adverse neurodevelopmental outcomes.
Conclusions:
- Prophylactic artificial surfactant treatment enhances neonatal survival in very preterm infants.
- This improved survival is not associated with a higher incidence of neurodevelopmental impairment.
- Artificial surfactant therapy is a safe and effective intervention for improving outcomes in premature infants.
Abstract:
Of 235 survivors who had taken part in a randomised trial of artificial surfactant and who were born in Cambridge, follow up information was available for 231 (98%) infants. In 12 cases information came from local doctors; all others were assessed at 9 and 18 months (n = 212) or 9 months only (n = 7). There was no difference between those who had been treated with surfactant and control babies in the incidence of neurological impairment, mental impairment, respiratory infections, allergies, or hospital admissions up to 18 months after full term. In those born before 30 weeks' gestation (where surfactant most improves survival) the number of surviving randomised children who were normal was 35 of 61 in the treated group (57%) compared with 25 of 61 in the control group (41%). Improved neonatal survival after prophylactic surfactant treatment is not associated with an increased incidence of neurodevelopmental impairment.