Post-Vent, the Sequelae: Personalized Prognostic Modeling for Consequences of Neonatal Intermittent Hypoxemia in Preterm Infants at Pre-School Age

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Project Summary / Abstract This is the application from collaborators of the Prematurity-Related Ventilatory Control (Pre-Vent): Role in Respiratory Outcomes NHLBI Collaborative Program. Central to this proposal is a prospective study entitled “Post-Vent, the Sequelae: Personalized Prognostic Modeling for Consequences of Neonatal Intermittent Hypoxemia in Preterm Infants at Pre-school Age”. This multicenter proposal innovatively combines detailed clinical phenotyping with advanced analytics of longitudinal recordings of intermittent hypoxemia (IH) events to develop personalized prognostic models of long-term outcomes that could transform clinical care by allowing for timely identification of at-risk infants and specific pathologic IH patterns for future trials of targeted intervention. Extremely premature birth and various postnatal factors can negatively affect outcome. In a significant proportion of extremely premature infants the sequelae persist beyond infancy with relatively high rates of asthma and sleep disordered breathing (SDB) in childhood and worrisome prevalence of neurodevelopmental impairment (NDI). This multicenter proposal will systematically and innovatively examine the interaction between IH during neonatal intensive care and these sequelae by means of detailed clinical phenotyping and advanced analytics. The proposed investigation will provide personalized prognosis and identification of infants at risk of poor long-term outcome that could transform clinical care and uncover targets for preventive or therapeutic strategies. The main goal of this proposal is to build prognostic models of asthma, SDB, and NDI at pre-school age in former extremely premature infants based on physiologic waveforms and clinical characteristics in the neonatal intensive care unit. To achieve this goal this time-sensitive proposal leverages the population, research structure and expertise, and analytic resources developed for the NHLBI-funded Pre-Vent collaboration.