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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Perinatal risk-indicators for long-term respiratory morbidity among preterm or very low birth weight neonates

Margreet J Teune1, Aleid G van Wassenaer, Stef van Buuren

  • 1Department of Obstetrics & Gynaecology, Academic Medical Center, The Netherlands. m.j.teune@amc.uva.nl

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|May 15, 2012
PubMed

Insights

Respiratory distress syndrome (RDS) does not predict long-term respiratory issues in premature infants. Bronchopulmonary dysplasia (BPD) and other perinatal factors are more significant indicators of future respiratory morbidity.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Perinatal Epidemiology

Background:

  • Premature infants face increased risks of long-term respiratory morbidity.
  • Identifying reliable predictors of respiratory outcomes is crucial for early intervention.
  • Respiratory distress syndrome (RDS) has been considered a potential indicator, but its long-term predictive value requires further investigation.

Purpose of the Study:

  • To develop prediction models for respiratory morbidity at 2, 5, and 19 years of age in a cohort of very preterm infants.
  • To evaluate whether RDS is a risk indicator for long-term respiratory morbidity.
  • To identify other perinatal risk factors associated with long-term respiratory morbidity.

Main Methods:

  • Prospective follow-up of 1338 infants born before 32 weeks gestation or with birth weight < 1500g in the Dutch POPS cohort.
  • Multivariable logistic regression analyses were used to construct prediction models.
  • Assessment of respiratory morbidity at 2, 5, and 19 years of age.

Main Results:

  • At 2 years, maternal smoking, prolonged rupture of membranes, pre-eclampsia, male gender, and bronchopulmonary dysplasia (BPD) were associated with respiratory morbidity.
  • At 5 years, prolonged rupture of membranes, family history of asthma, and BPD were significant predictors.
  • At 19 years, only higher social class was associated with decreased respiratory morbidity. RDS was not a significant predictor at any time point.
  • Prediction models for 2 and 5 years showed good calibration; the 19-year model calibration was less optimal.

Conclusions:

  • RDS is not a reliable risk indicator for long-term respiratory morbidity at 2, 5, or 19 years.
  • Bronchopulmonary dysplasia (BPD) is a more significant predictor of long-term respiratory morbidity than RDS.
  • Future studies on perinatal interventions should consider BPD as a primary outcome instead of RDS.
Abstract

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