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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
School-age follow-up of a single-dose prophylactic surfactant cohort
C L Wagner1, B M Kramer, J W Kendig
1Department of Pediatrics, University of Rochester Medical Center, New York, USA.
Insights
Surfactant therapy in premature infants did not cause long-term developmental issues. However, both treated and control groups showed risks for neurodevelopmental and educational problems at school age.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Pediatric Neurology
Background:
- Premature infants born between 25 to 29 weeks gestation are at risk for developmental and health issues.
- Surfactant therapy is a common treatment for respiratory distress syndrome in preterm infants.
- Long-term neurodevelopmental outcomes following early surfactant administration require further investigation.
Purpose of the Study:
- To assess the school-age developmental and health status of a cohort of preterm infants who received surfactant therapy.
- To compare the outcomes of infants who received surfactant with a control group treated with normal saline.
- To identify any long-term sequelae associated with surfactant therapy.
Main Methods:
- Longitudinal study of 39 surviving preterm infants (25–29 weeks gestation).
- Follow-up assessments at 6, 12 months, and 5–7 years of age.
- Evaluations included cognitive, motor, and behavioral assessments (McCarthy General Cognitive Index, Connors' Parental Questionnaire).
Main Results:
- No significant group differences in cognitive or motor assessments at school age.
- A substantial proportion in both surfactant (42%) and saline (53%) groups scored in the abnormal range on the McCarthy General Cognitive Index.
- Both groups reported high scores on the Learning Disability Subscale of the Connors' Parental Questionnaire.
Conclusions:
- Surfactant therapy did not result in identifiable long-term sequelae in this cohort of preterm infants.
- Both the surfactant-treated and control groups were at risk for neurodevelopmental and educational morbidity.
- Early surfactant administration appears safe regarding long-term development, but comprehensive monitoring for neurodevelopmental risks is crucial for all very preterm infants.
Abstract:
This study reports the school-age developmental and health status of a preventilatory surfactant cohort. The sample consisted of 39 surviving subjects (21 experimental and 18 controls) born at 25 to 29 weeks gestation who were studied at 6 and 12 months and 5 to 7 years of age. At 6- and 12-month follow-ups, the cohort was functioning close to the population normative mean. Although cognitive and motor assessments at school age also showed no group differences, 8 of 19 (42%) in the surfactant group and 9 of 17 (53%) in the normal saline group attained a McCarthy General Cognitive Index score of < or = 84 (abnormal range). On the Connors' Parental Questionnaire, both groups scored high on the Learning Disability Subscale. The surviving cohort at 5 to 7 years had no identified long-term sequelae due to surfactant therapy, yet both groups were at risk for neurodevelopmental and educational morbidity.
