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An Analysis of Predictors of Early Morbidity and Mortality in Infants with Robin Sequence
Rebecca C Lisk1, Lucas R Perez1, Rami S Kantar1
1Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.
Insights
The incidence of Robin Sequence is 1 in 3713 live births. Key predictors of morbidity and mortality include prematurity, prenatal drug exposure, and specific anomalies.
Area of Science:
- Pediatrics
- Medical Genetics
- Public Health
Background:
- Robin Sequence (RS) is a congenital condition affecting infant development.
- Understanding RS incidence and associated risk factors is crucial for early intervention.
Purpose of the Study:
- To determine the incidence of Robin Sequence in the US.
- To identify predictors of early morbidity and mortality in infants with RS.
Main Methods:
- Retrospective cohort study using the Epic Cosmos database (2015-2024).
- Included patients diagnosed with RS within the first year of life.
- Analyzed associations with prenatal drug exposure, prematurity, IUGR, airway diagnoses, genetic syndromes, and organ anomalies.
Main Results:
- Identified 3863 patients, an incidence of 1 in 3713 live births.
- Significant associations found between NICU admission/readmission and factors like prematurity, prenatal drug exposure, and specific anomalies (cardiopulmonary, CNS).
- One-year mortality linked to prematurity, IUGR, and cardiopulmonary/CNS anomalies.
Conclusions:
- Perinatal factors, airway diagnoses, and cardiopulmonary/CNS anomalies significantly impact RS morbidity and mortality.
- Emphasizes the need for comprehensive early evaluation in infants with Robin Sequence.
Abstract:
ObjectiveTo assess the incidence of Robin Sequence in the United States and evaluate predictors of early morbidity and mortality.DesignRetrospective cohort study.SettingEpic Cosmos database.Patients, ParticipantsPatients with Robin Sequence diagnosed within the first year of life from January 2015 to December 2024.InterventionsVariables including prenatal drug exposure (PDE), prematurity, intrauterine growth restriction (IUGR), concomitant airway diagnoses, genetic syndromes, and anomalies of the cardiopulmonary, gastrointestinal, or central nervous system (CNS) were captured.Main Outcome Measure(s)Incidence across a 10-year period and associations with admission to the neonatal intensive care unit (NICU) and length of stay (LOS), 30-day readmission and ED visit, and one-year mortality through a multivariate logistic regression.Results3863 patients were identified, for an incidence of 1 in 3713 live births. NICU admission was significantly associated with PDE, prematurity, IUGR, tracheomalacia, laryngomalacia, cleft palate, and presence of a cardiopulmonary or CNS anomaly. NICU LOS was associated with prematurity, bronchomalacia, and the presence of a gastrointestinal anomaly. 30-day readmission was associated with PDE, prematurity, tracheomalacia, laryngomalacia, cleft palate, cardiopulmonary anomalies, and CNS anomalies. 30-day ED visit was associated with prematurity, tracheomalacia, cleft palate, cardiopulmonary anomalies, and CNS anomalies. One-year mortality was associated with prematurity, IUGR, cardiopulmonary anomalies, and CNS anomalies.ConclusionsSignificant associations were identified between morbidity and mortality and perinatal factors, concomitant airway diagnoses, and the presence of cardiopulmonary and CNS anomalies. These findings underscore the importance of an early comprehensive evaluation for patients with Robin Sequence.
