Correlations between oxygen and positive pressure exposure in the neonatal intensive care unit and wheezing in preterm infants without bronchopulmonary dysplasia
Affiliations: [a]
Department of Pediatrics, UH Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
| [b]
Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| [c]
Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| [d]
Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
Correspondence:
[*]
Address for correspondence: Tara Glenn, MD, 11100 Euclid Avenue, MS 6010, Cleveland, OH 44106, USA. Tel.: +1 216 844 3387; Fax: +1 216 844 3380; E-mail: [email protected].
Abstract: BACKGROUND:Oxygen exposure has been associated with increased wheezing and respiratory morbidity after discharge in extremely preterm infants and those with bronchopulmonary dysplasia. More mature preterm infants with less severe disease are also at risk for pulmonary complications, including rehospitalization for respiratory illnesses and wheezing disorders. Our aim was to evaluate associations between respiratory support and morbidity in preterm infants without bronchopulmonary dysplasia. METHODS:A secondary analysis was performed on 300 infants born at 28–34 weeks gestation without bronchopulmonary dysplasia. Exposure included oxygen or positive pressure, (continuous positive airway pressure or mechanical ventilation). The primary outcome was recurrent wheezing. Secondary outcomes were respiratory medications, emergency room visits, and hospitalizations. RESULTS:50% of infants who received oxygen experienced recurrent wheezing compared to 42.4% of infants who did not (OR 1.15 CI 0.72–1.85 adjusted OR 1.15 CI 0.67–1.98). 51.1% of infants who received positive pressure experienced recurrent wheezing compared to 38.1% who did not (OR 1.57 CI 0.97–2.53 adjusted OR 1.58 CI 0.90–2.77). There were no significant associations between oxygen and positive pressure exposure and any primary or secondary outcomes in the adjusted analyses. CONCLUSIONS:After adjustment for known risk factors the analyses showed no significant associations between oxygen and positive pressure with respiratory morbidity in this population. Further study of infants with mild disease is needed.
