Risk Factors of Mechanical Ventilation in Premature Infants During Hospitalization

The purpose of this study was to identify the risk factors for premature neonates requiring mechanical ventilation.

Premature neonates admitted to Chengdu Women's and Children's Central Hospital between July 2014 and December 2020 were retrospectively included in this study. Clinical and demographic factors were collated. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for premature infants requiring mechanical ventilation.

A total of 1262 premature neonates participated in the study. Among them, 423 (33.53%) neonates required mechanical ventilation, whereas 839 (66.48%) neonates did not require mechanical ventilation. Multivariate logistic regression analysis determined that a lower Apgar score at 5 min (OR = 0.595, 95% CI: 0.472-0.74; P < 0.001), lower gestational age (very preterm) (OR = 11.745, 95% CI: 4.362, 31.619, P < 0.001), lower systolic blood pressure (OR = 0.864, 95% CI: 0.812-0.917, P = 0.001), lower diastolic blood pressure (OR = 0.894, 95% CI: 0.831-0.96, P = 0.002), higher respiratory rate (OR = 1.292, 95% CI: 1.238-1.355, P < 0.001), increased C-reactive protein levels (OR=1.044, 95% CI: 1.003-1.086, P = 0.036), and presence of patent ductus arteriosus (OR = 2.174, 95% CI: 1.185-3.972, P = 0.012) were independently associated with an increased possibility of adopting mechanical ventilation in premature infants. ROC analysis demonstrated that the predicted power for premature neonates requiring mechanical ventilation was 0.855 (95% CI: 0.808-0.902, P < 0.001).

In conclusion, we determined that a lower Apgar score at 5 min, lower gestational age, lower systolic blood pressure, lower diastolic blood pressure, higher respiratory rate, increased C-reactive protein levels and presence of patent ductus arteriosus were independently associated with an increased possibility of adopting mechanical ventilation in premature infants.