Association of time of first corticosteroid treatment with bronchopulmonary dysplasia in preterm infants.
Association of time of first corticosteroid treatment with bronchopulmonary dysplasia in preterm infants.
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DOI：
10.1002/ppul.25610
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发表时间：
2021-10
影响因子：
3.1
通讯作者：
Children's Hospitals Neonatal Consortium (CHNC) Severe BPD Focus Group
中科院分区：
文献类型：
--
作者：
Cuna A;Lagatta JM;Savani RC;Vyas-Read S;Engle WA;Rose RS;DiGeronimo R;Logan JW;Mikhael M;Natarajan G;Truog WE;Kielt M;Murthy K;Zaniletti I;Lewis TR;Children's Hospitals Neonatal Consortium (CHNC) Severe BPD Focus Group
目的探讨早产儿首次全身应用糖皮质激素时间与支气管肺发育不良(BPD)的关系。使用儿童医院新生儿数据库和儿科健康信息系统数据库进行了一项从2010年1月到2016年12月的多中心回顾性队列研究。研究人群包括早产儿和32周妊娠，在7天后和34周月经后使用全身皮质类固醇治疗。使用逐步多变量Logistic回归分析皮质类固醇开始使用的时间与2019年新生儿研究网络标准所定义的2级或3级BPD的发展之间的相关性。我们确定了598名接受皮质类固醇治疗的婴儿(胎龄中位数25周，出生体重中位数760克)。其中，47%(280/598)在8~21天开始治疗，25%(148/598)在22~35天开始治疗，14%(86/598)在36~49天开始治疗，14%(84/598)在50天开始治疗。与在调整出生特征、入院特征、中心和合并症后8-21天接受治疗的婴儿相比，在36-49天(AOR 2.0，95%可信区间1.1-3.7)和50天(AOR 1.9，95%可信区间1.04-3.3)首次治疗的婴儿发生2级或3桶/日的独立几率更高。在常规临床实践中接受全身皮质类固醇治疗的早产儿中，与早期治疗相比，较晚开始治疗的早产儿发生2级或3级BPD的可能性更高。
To evaluate the association between the time of first systemic corticosteroid initiation and bronchopulmonary dysplasia (BPD) in preterm infants. A multi-center retrospective cohort study from January 2010 to December 2016 using the Children’s Hospitals Neonatal Database and Pediatric Health Information System database was conducted. The study population included preterm infants <32 weeks’ gestation treated with systemic corticosteroids after seven days of age and before 34 weeks’ postmenstrual age. Stepwise multivariable logistic regression was used to assess the association between timing of corticosteroid initiation and the development of Grade 2 or 3 BPD as defined by the 2019 Neonatal Research Network criteria. We identified 598 corticosteroid-treated infants (median gestational age 25 weeks, median birth weight 760 grams). Of these, 47% (280/598) were first treated at 8–21 days, 25% (148/598) were first treated at 22–35 days, 14% (86/598) were first treated at 36–49 days, and 14% (84/598) were first treated at > 50 days. Infants first treated at 36–49 days (aOR 2.0, 95% CI 1.1–3.7) and > 50 days (aOR 1.9, 95% CI 1.04–3.3) had higher independent odds of developing Grade 2 or 3 BPD when compared to infants treated at 8–21 days after adjusting for birth characteristics, admission characteristics, center, and co-morbidities. Among preterm infants treated with systemic corticosteroids in routine clinical practice, later initiation of treatment was associated with a higher likelihood to develop Grade 2 or 3 BPD when compared to earlier treatment.
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影响因子：
8
作者：
Doyle, LW;Davis, PG;Carlin, JB
通讯作者：
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