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Neurodevelopmental outcomes of preterm infants resuscitated with different oxygen concentration at birth

Abstract

Objective:

To compare the neurodevelopmental outcomes at 18 to 21 months corrected age (CA) of infants born at <29 weeks that received room air, an intermediate oxygen concentration or 100% oxygen at the initiation of resuscitation.

Study design:

In this retrospective cohort study, we compared neonatal and neurodevelopmental outcomes at 18 to 21 months CA among inborn infants born before 29 weeks’ gestation that received room air, intermediate oxygen concentration or 100% oxygen at the initiation of resuscitation.

Results:

Of 1509 infants, 445 received room air, 483 received intermediate oxygen concentrations and 581 received 100% oxygen. Compared to infants that received room air, the primary outcome of death or neurodevelopmental impairment (NDI) was not different in intermediate oxygen (adjusted odds ratio (aOR) 1.01; 95% confidence interval (CI) 0.77, 1.34) or 100% oxygen (aOR 1.03; 95% CI 0.78, 1.35). Compared to room air, there was no difference in odds of death or severe NDI in intermediate oxygen (aOR 1.14; 95% CI 0.82, 1.58) or 100% oxygen group (aOR 1.22; 95% CI 0.90, 1.67). The odds of severe NDI among survivors were significantly higher in infants that received 100% oxygen as compared to room air (aOR 1.57, 95% CI 1.05, 2.35).

Conclusions:

We observed no significant difference in the primary composite outcomes of death or NDI and death or severe NDI at 18 to 21 months CA between infants that received room air, intermediate oxygen concentration or 100% oxygen at the initiation of resuscitation. However, use of 100% oxygen was associated with increased odds of severe NDI among survivors as compared to room air.

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Acknowledgements

We would like to acknowledge the staff of the Canadian Neonatal Network and Canadian neonatal Follow-up Network coordinating center for their tireless and diligent work and Natasha Musrap, PhD, (Maternal Infant Care Research Centre, Mount Sinai Hospital) for editorial assistance. The Maternal-Infant Care Research Centre is supported by the Ontario Ministry of Health and Long-Term Care. Organizational support to the Canadian Neonatal Network is provided by the Canadian Institutes of Health Research-funded Team in Maternal-Infant Care. We thank the data abstractors of the CNN, staff of the CNN and CNFUN coordinating centers for providing organizational support, and all CNN and CNFUN site investigators. Administrative and statistical support for the study was provided by the Canadian Neonatal Network Coordinating Centre at the Maternal-Infant Research Centre, Mount Sinai Hospital, Toronto, Ontario. The Maternal-Infant Research Centre is supported by funding from the Canadian Institutes of Health Research (CIHR) (CTP87518) and the Ministry of Health and Long-Term Care, Ontario, Canada.

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Correspondence to A S Soraisham.

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Members of the investigators of the Canadian Neonatal Network and Canadian Neonatal Follow up Network

A Synnes5, PS Shah6, A Harrison7, T Pillay7, Z Cieslak8, T Sorokan9, R Sherlock9, J Ting10, W Yee11, R Sauve11, K Aziz12, Z Kalapesi13, J Bodani13, K Sankaran14, S Daspal14, M Seshia15 and D Moddemann15, R Alvaro16, S Shivananda17, S el Helou17, O DaSilva18, D Lee18, C Nwaesei19, KS Lee20, L Ly20, E Kelly21, M Dunn22, P Church22, N Rouvinez-Bouali23, Brigitte Lemyre23, T Daboval23, K Dow24, E Pelausa25, K Barrington26, F Lefebvre26, C Drolet27, S Belanger27, P Riley28, M Claveau28, D Faucher29, V Bertelle30, E Masse30, C Demers30, R Canning31, B Bulleid32, H Makary32, C Ojah33, L Monterrosa33, A Deshpandey34, P Murphy34, J Afifi35, M Vincer35, A Kajetanowicz36, SK Lee37

5Children’s & Women’s Health Centre of British Columbia, Vancouver, BC, Canada; 6Mount Sinai Hospital, Toronto, Ontario; 7Victoria General Hospital, Victoria, BC, Canada; 8Royal Columbian Hospital, New Westminster, BC, Canada; 9Surrey Memorial Hospital, Surrey, BC, Canada; 10Children’s & Women’s Health Centre of British Columbia, Vancouver, BC, Canada; 11Foothills Medical Centre, Calgary, AB, Canada; 12Royal Alexandra Hospital, A. Reichert, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada; 13Regina General Hospital, Regina, SK, Canada; 14Royal University Hospital, Saskatoon, SK, Canada; 15Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 16St. Boniface General Hospital, Winnipeg, MB, Canada; 17Hamilton Health Sciences Centre, Hamilton, ON, Canada; 18London Health Sciences Centre, London, ON, Canada; 19Windsor Regional Hospital, Windsor, ON, Canada; 20Hospital for Sick Children, Toronto, ON, Canada; 21Mount Sinai Hospital, Toronto, ON, Canada; 22Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 23Children’s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 24Kingston General Hospital, Kingston, ON, Canada; 25Jewish General Hospital, Montreal, QC, Canada; 26Hopital Sainte-Justine, Montreal, QC, Canada; 27Centre Hospitalier Universitaire de Quebec, Sainte-Foy, QC, Canada; 28Montreal Children’s Hospital, Montreal, QC, Canada; 29Royal Victoria Hospital, Montreal, QC, Canada; 30Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 31Moncton Hospital, Moncton, NB, Canada; 32Dr Everett Chalmers Hospital, Fredericton, NB, Canada; 33Saint John Regional Hospital, Saint John, NB, Canada; 34Janeway Children’s Health and Rehabilitation Centre, St. John’s, NL, Canada; 35IWK Health Centre, Halifax, NS, Canada; 36Cape Breton Regional Hospital, Sydney, NS, Canada; 37Mount Sinai Hospital, Toronto, ON, Canada.

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Soraisham, A., Rabi, Y., Shah, P. et al. Neurodevelopmental outcomes of preterm infants resuscitated with different oxygen concentration at birth. J Perinatol 37, 1141–1147 (2017). https://doi.org/10.1038/jp.2017.83

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