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1. Respiratory Medications in Infants <29 Weeks during the First Year Postdischarge: The Prematurity and Respiratory Outcomes Program (PROP) Consortium

Author

Rita M. Ryan, Roberta L. Keller, Brenda B. Poindexter, Carl T. D'Angio, Pamela A. Shaw, Scarlett L. Bellamy, Paul E. Moore, Christopher McPherson, James M. Greenberg, Barbara Alexander, Tari Gratton, Cathy Grigsby, Beth Koch, Kelly Thornton, Pamela Bates, Claudia Cleveland, Julie Hoffmann, Laura Linneman, Jayne Sicard-Su, Gina Simpson, Jeanette M. Asselin, Samantha Balan, Katrina Burson, Cheryl Chapin, Erna Josiah-Davis, Carmen Garcia, Hart Horneman, Rick Hinojosa, Christopher Johnson, Susan Kelley, Karin L. Knowles, M. Layne Lillie, Karen Martin, Sarah Martin, Julie Arldt-McAlister, Georgia E. McDavid, Lori Pacello, Shawna Rodgers, Daniel K. Sperry, Amy B. Beller, Mark O’ Hunt, Theresa J. Rogers, Odessa L. Settles, Steven Steele, Sharon Wadley, Shannon Castiglione, Aimee Horan, Deanna Maffet, Jane O'Donnell, Michael Sacilowski, Tanya Scalise, Elizabeth Werner, Jason Zayac, Heidie Huyck, Valerie Lunger, Kim Bordeaux, Pam Brown, Julia Epping, Lisa Flattery-Walsh, Donna Germuga, Nancy Jenks, Mary Platt, Eileen Popplewell, Sandra Prentice, Kim Ciccio, Charles Clem, Susan Gunn, Lauren Jewett, Maria Blanco, Denise Cifelli, Sara DeMauro, Melissa Fernando, Ann Tierney, Lynn M. Taussig, Carol J. Blaisdell, Claire Chougnet, William Hardie, Alan H. Jobe, Karen McDowell, Thomas Ferkol, Aaron Hamvas, Mark R. Holland, James Kemp, Philip T. Levy, Phillip Tarr, Gautam K. Singh, Barbara Warner, Philip L. Ballard, Roberta A. Ballard, David J. Durand, Eric C. Eichenwald, Amir M. Khan, Leslie Lusk, Jeffrey D. Merrill, Dennis W. Nielson, Elizabeth E. Rogers, Judy Aschner, Candice Fike, Scott Guthrie, Tina Hartert, Nathalie Maitre, Marshall Summar, Vasanth Kumar, Tom Mariani, Gloria Pryhuber, Clement Ren, Anne Marie Reynolds, Kristin Scheible, Timothy Stevens, C. Michael Cotten, Kim Fisher, Jack Sharp, Judith A. Voynow, Stephanie Davis, Jonas Ellenberg, Rui Feng, Howard Panitch, and Barbara Schmidt

Subjects
Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, medicine.drug_class, medicine.medical_treatment, Anti-Inflammatory Agents, Gestational Age, Infant, Premature, Diseases, Article, 03 medical and health sciences, 0302 clinical medicine, Prednisone, Intensive Care Units, Neonatal, Surveys and Questionnaires, 030225 pediatrics, Bronchodilator, Administration, Inhalation, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Respiratory system, Diuretics, Prospective cohort study, Bronchopulmonary Dysplasia, business.industry, Infant, Newborn, Infant, Gestational age, medicine.disease, Patient Discharge, Bronchodilator Agents, Oxygen, Treatment Outcome, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Female, Steroids, Diuretic, business, Infant, Premature, medicine.drug
Abstract

OBJECTIVE: To determine patterns of respiratory medications used in neonatal intensive care unit (NICU) graduates. STUDY DESIGN: The Prematurity Respiratory Outcomes Program enrolled 835 babies

Published
2019

2. Bronchopulmonary Dysplasia and Perinatal Characteristics Predict 1-Year Respiratory Outcomes in Newborns Born at Extremely Low Gestational Age: A Prospective Cohort Study

Author

Julia Epping, Theresa J. Rogers, Carl T. D'Angio, Nathalie L. Maitre, Marshall L. Summar, Erna Josiah-Davis, Maria Blanco, Jane O'Donnell, T.J. Mariani, Samantha Balan, Vasantha H.S. Kumar, Rita M. Ryan, Scarlett L. Bellamy, Dennis W. Nielson, Philip T. Levy, Melissa Fernando, Barbara Warner, David J. Durand, Shawna Rodgers, Steven Steele, Susan Kelley, Scott O Guthrie, Carmen Garcia, Anne Marie Reynolds, Karin L. Knowles, William D. Hardie, Jeffrey D. Merrill, Barbara Alexander, Timothy P. Stevens, Claudia Cleveland, Valerie Lunger, Julie A. Hoffmann, Karen M. McDowell, Donna Germuga, Elizabeth E. Rogers, Karen Martin, Jason Zayac, Laura Linneman, Gautam K. Singh, Kim Bordeaux, Deanna Maffet, Clement L. Ren, Lisa Flattery-Walsh, Stephanie D. Davis, Jack K. Sharp, Gina Simpson, Jonas H. Ellenberg, Aimee Horan, Lynn M. Taussig, Hart F. Horneman, Mark O'Hunt, Amy Beller, Elizabeth R. Werner, Charles Clem, Roberta A. Ballard, Thomas W. Ferkol, Katrina Burson, Jayne Sicard-Su, Tanya Scalise, Sarah Martin, Eileen Popplewell, M. Layne Lillie, Kim Ciccio, Shannon Castiglione, Carol J. Blaisdell, Lori Pacello, Philip L. Ballard, C. Michael Cotten, Brenda B. Poindexter, Tari Gratton, Sharon Wadley, Mary Jane Platt, Ann Tierney, Daniel K. Sperry, Kelly Thornton, Kristin Scheible, Roberta L. Keller, Pamela A. Shaw, Judith A. Voynow, Claire A. Chougnet, Kim Fisher, Georgia E. McDavid, Rick Hinojosa, Sandra Prentice, James M. Greenberg, Rui Feng, Jeanette M. Asselin, Barbara Schmidt, Pamela Bates, Susan Gunn, Denise Cifelli, Christopher Johnson, Howard B. Panitch, Cheryl J. Chapin, Heidie Huyck, Cathy Grisby, Tina V. Hartert, Amir M. Khan, Sara B. DeMauro, Lauren Jewett, Judy L. Aschner, Julie Arldt-McAlister, Aaron Hamvas, Leslie A. Lusk, James Kemp, Beth Koch, Pam Brown, Gloria S. Pryhuber, Candice D. Fike, Alan H. Jobe, Mark R. Holland, Michael G. Sacilowski, Odessa L. Settles, Nancy Jenks, Paul E. Moore, and Eric C. Eichenwald

Subjects
Male, Pediatrics, medicine.medical_specialty, Intrauterine growth restriction, Gestational Age, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, 030225 pediatrics, Wheeze, medicine, Humans, Infant, Very Low Birth Weight, Prospective Studies, Prospective cohort study, Lung, Bronchopulmonary Dysplasia, Obstetrics, business.industry, Parturition, Infant, Newborn, Gestational age, Infant, medicine.disease, Prognosis, Health Surveys, medicine.anatomical_structure, 030228 respiratory system, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, Morbidity, business, Cohort study
Abstract

To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs).We enrolled ELGANs (29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonatal clinical data through 36 weeks' postmenstrual age. We surveyed caregivers at 3, 6, 9, and 12 months' corrected age to identify postdischarge respiratory morbidity, defined as hospitalization, home support (oxygen, tracheostomy, ventilation), medications, or symptoms (cough/wheeze). Infants were classified as having postprematurity respiratory disease (PRD, the primary study outcome) if respiratory morbidity persisted over ≥2 questionnaires. Infants were classified with severe respiratory morbidity if there were multiple hospitalizations, exposure to systemic steroids or pulmonary vasodilators, home oxygen after 3 months or mechanical ventilation, or symptoms despite inhaled corticosteroids. Mixed-effects models generated with data available at 1 day (perinatal) and 36 weeks' postmenstrual age were assessed for predictive accuracy.Of 724 infants (918 ± 234 g, 26.7 ± 1.4 weeks' gestational age) classified for the primary outcome, 68.6% had PRD; 245 of 704 (34.8%) were classified as severe. Male sex, intrauterine growth restriction, maternal smoking, race/ethnicity, intubation at birth, and public insurance were retained in perinatal and 36-week models for both PRD and respiratory morbidity severity. The perinatal model accurately predicted PRD (c-statistic 0.858). Neither the 36-week model nor the addition of bronchopulmonary dysplasia to the perinatal model improved accuracy (0.856, 0.860); c-statistic for BPD alone was 0.907.Both bronchopulmonary dysplasia and perinatal clinical data accurately identify ELGANs at risk for persistent and severe respiratory morbidity at 1 year.ClinicalTrials.gov: NCT01435187.

Published
2016

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