Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity
Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity
复制标题
多沙普仑治疗早产儿呼吸暂停后的长期神经发育结果
作者：
C. T. ten Hove;R. Vliegenthart;A. T. te Pas;Emma Brouwer;M. Rijken;A. V. van Wassenaer;A. V. van Kaam;W. Onland
背景：多沙普仑一直被认为是治疗持续性早产儿呼吸暂停（AOP）的一种方法。目的：评价多沙普仑对早产儿长期神经发育结局的影响，因为其安全性仍需确定。研究方法：从2000年至2010年出生的胎龄（GA）<30周和/或出生体重<1，250 g的早产儿的回顾性队列中，选择了多沙普仑治疗的婴儿（n = 142）和未治疗的对照组（n = 284）。收集了24个月校正年龄时的患者特征以及临床和神经发育结局数据。神经发育迟缓（ND）定义为精神或心理发育指数（MDI/PDI）<-1标准差（SD）、脑瘫或听力或视力障碍。采用多元逻辑回归分析计算比值比（OR），调整潜在混杂因素。结果：与对照组相比，多沙普仑治疗的婴儿具有较低的GA。MDI或PDI <-1 SD的婴儿数量在两组之间没有差异。在调整混杂因素后，多沙普仑组的合并结局死亡或ND的风险显著降低（OR = 0.54，95%CI：0.37，0.78）。多沙普仑治疗的婴儿发生支气管肺发育不良和动脉导管未闭的风险较高，但自发性肠穿孔的风险较低。所有其他发病率在两组之间没有差异。结论：这项研究表明，多沙普仑与ND的风险增加无关。这些发现需要通过一个大型的、设计良好的、安慰剂对照的随机试验来证实或反驳。
Background: Doxapram has been advocated as a treatment for persistent apnea of prematurity (AOP). Objective: To evaluate the effect of doxapram on long-term neurodevelopmental outcome in preterm infants as its safety still needs to be established. Methods: From a retrospective cohort of preterm infants with a gestational age (GA) <30 weeks and/or a birth weight <1,250 g, born between 2000 and 2010, infants treated with doxapram (n = 142) and a nontreated control group were selected (n = 284). Patient characteristics and clinical and neurodevelopmental outcome data at 24 months' corrected age were collected. Neurodevelopmental delay (ND) was defined as having a Mental or Psychomotor Developmental Index (MDI/PDI) <-1 standard deviation (SD), cerebral palsy, or a hearing or visual impairment. Odds ratios (OR) were calculated using multiple logistic regression analyses adjusting for potential confounders. Results: Infants treated with doxapram had a lower GA compared to controls. The number of infants with a MDI or PDI <-1 SD was not different between the groups. The risk of the combined outcome death or ND was significantly lower in the doxapram group after adjusting for confounding factors (OR = 0.54, 95% CI: 0.37, 0.78). Doxapram-treated infants had a higher risk of bronchopulmonary dysplasia and patent ductus arteriosus, but a lower risk of spontaneous intestinal perforation. All other morbidities were not different between the groups. Conclusions: This study suggests that doxapram is not associated with an increased risk of ND. These findings need to be confirmed or refuted by a large, well-designed, placebo-controlled randomized trial.
影响因子：
5.1
作者：
Walsh, MC;Morris, BH;Fanaroff, AA
通讯作者：
Fanaroff, AA
影响因子：
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作者：
Short, Elizabeth J.;Kirchner, Lester;Singer, Lynn T.
通讯作者：
Singer, Lynn T.