Perinatal Airway Management Mandibular Anomalies: A National Inpatient Cohort Analysis

Area of Science:

• Pediatric Surgery
• Neonatology
• Craniofacial Anomalies

Background:

• Mandibular anomalies (MAs) encompass a spectrum of conditions affecting jaw development.
• These anomalies can significantly impact airway patency and require specialized medical attention.
• Understanding the incidence and outcomes associated with MAs is crucial for improving patient care.

Purpose of the Study:

• To determine the incidence of various mandibular anomaly (MA) phenotypes.
• To compare gestational age, airway interventions, and complications in infants with different MA phenotypes versus unaffected infants.
• To evaluate the effectiveness of current airway management in MA patients.

Main Methods:

• Utilized the Healthcare Cost and Utilization Project Kids' Inpatient Database (2000-2020).
• Classified airway interventions as perinatal (day of life 0-1) or subsequent.
• Defined hypoxic complications and compared groups using descriptive statistics and Rao-Scott chi-square test.

Main Results:

• MAs occurred in 119 per 100,000 birth visits, with preterm delivery more frequent across all phenotypes.
• Infants with MAs had significantly higher rates of requiring medical attention (16.2%-70.7% vs. 3.8%).
• Despite higher rates of early airway intervention, MA patients had a mildly elevated risk of hypoxic complications or mortality (32.4% vs. 26.4%).

Conclusions:

• Preterm birth is common in MAs but does not fully explain the increased need for airway intervention.
• Individuals with MAs require more medical attention, highlighting a gap in current care.
• Existing airway management protocols are inadequate for preventing complications and mortality in infants with MAs.