Delivery room intubation and neurodevelopment among extremely preterm infants

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Perinatal Research

Background:

• The long-term neurodevelopmental outcomes following delivery room intubation (DRI) in extremely preterm infants remain incompletely understood.
• Existing research on DRI's impact on neurodevelopment in this population has yielded inconsistent findings.

Purpose of the Study:

• To investigate the association between delivery room intubation and neurodevelopmental impairment (NDI) at age 3 years in infants born extremely preterm.
• To analyze the components of NDI and mortality rates in relation to DRI.

Main Methods:

• Retrospective analysis of data from infants born between 24-27 gestational weeks (2003-2018).
• Primary outcome: NDI (cerebral palsy, hearing, visual, or cognitive impairment) at age 3.
• Secondary outcomes: NDI components and mortality. Robust Poisson regression was used for analysis, adjusting for perinatal confounders.

Main Results:

• The study included 4397 infants; 3703 underwent DRI and 694 did not.
• Infants with DRI had a higher risk of NDI (32.4% vs. 23.3%; adjusted risk ratio: 1.18, 95% CI: 1.01-1.37).
• No significant differences were observed in secondary outcomes (NDI components, mortality) between the groups.

Conclusions:

• Delivery room intubation is associated with an increased risk of neurodevelopmental impairment at age 3 years in extremely preterm infants.
• These findings underscore the importance of careful consideration regarding the timing and necessity of DRI in this vulnerable population.