Prolonged ventilation and postnatal growth of preterm infants

Area of Science:

• Neonatalogy
• Pediatric Critical Care
• Developmental Pediatrics

Background:

• Extremely premature infants (<28 weeks gestational age) often require invasive respiratory support.
• These infants have limited nutritional reserves and high metabolic demands.
• Understanding factors affecting their growth is crucial for optimizing care.

Purpose of the Study:

• To investigate the relationship between the duration of invasive mechanical ventilation and postnatal growth in extremely premature infants.
• To identify potential associations between ventilation duration and changes in weight and head circumference z-scores.

Main Methods:

• Retrospective observational study of infants born at <28 weeks gestational age requiring invasive mechanical ventilation for ≥7 days.
• Data collected included gestational age, birth/discharge weight, birth/discharge head circumference, ventilation duration, and corticosteroid use.
• Calculated differences in weight (ΔWz) and head circumference (ΔHz) z-scores from birth to discharge.

Main Results:

• Study included 55 infants with a median gestational age of 25.3 weeks.
• Median mechanical ventilation duration was 45 days.
• Both ΔWz and ΔHz showed significant negative correlations with the number of invasive mechanical ventilation days (P=0.01 and P=0.03, respectively).

Conclusions:

• Prolonged invasive mechanical ventilation is significantly associated with poorer postnatal growth in extremely premature infants.
• The duration of ventilation, not postnatal corticosteroid use, was linked to reduced weight and head circumference growth.
• Findings highlight the impact of respiratory support duration on infant development.