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Characterizing continuous positive airway pressure (CPAP) Belly Syndrome in preterm infants in the neonatal intensive care unit (NICU)

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Objective

Reproducibly define CPAP Belly Syndrome (CBS) in preterm infants and describe associated demographics, mechanical factors, and outcomes.

Study design

A retrospective case-control study was conducted in infants <32 weeks gestation in the Stanford Children’s NICU from January 1, 2020 to December 31, 2021. CBS was radiographically defined by a pediatric radiologist. Data analysis included descriptive statistics and comparator tests.

Results

Analysis included 41 infants with CBS and 69 infants without. CBS was associated with younger gestational age (median 27.7 vs 30 weeks, p < 0.001) and lower birthweight (median 1.00 vs 1.31 kg, p < 0.001). Infants with CBS were more likely to receive bilevel respiratory support and higher positive end expiratory pressure. Infants with CBS took longer to advance enteral feeds (median 10 vs 7 days, p = 0.003) and were exposed to more abdominal radiographs.

Conclusions

Future CBS therapies should target small infants, prevent air entry from above, and aim to reduce time to full enteral feeds and radiographic exposure.

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Fig. 1: Representations of the abdominal radiograph classification system used in this study.
Fig. 2: In total, 229 preterm infants ≤32 weeks gestation were admitted to the Stanford NICU in the first 28 days of life (DOL) from January 1, 2020 to December 31, 2021.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors extend gratitude to Impact1 and the Stanford Byers Center for Biodesign for early assistance in conceptualizing this project.

Author information

Authors and Affiliations

  1. Division of Neonatology, Stanford University, Stanford, CA, USA

    Hannah Gu, Louis P. Halamek & Janene H. Fuerch

  2. Department of Pediatric Radiology, Stanford University, Stanford, CA, USA

    Jayne Seekins

  3. Quantitative Sciences Unit, Stanford University, Stanford, CA, USA

    Victor Ritter

  4. Department of Pediatric General Surgery, Stanford University, Stanford, CA, USA

    James K. Wall

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  1. Hannah Gu
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Contributions

Hannah Gu: conceptualization, methodology, formal analysis, investigation, writing – original draft. Jayne Seekins: methadology. Victor Ritter: methodology, formal analysis. Louis P. Halamek: conceptualization, writing – review and editing. James K. Wall: conceptualization. Janene H. Fuerch: conceptualization, writing – review and editing, supervision.

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Correspondence to Hannah Gu.

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Gu, H., Seekins, J., Ritter, V. et al. Characterizing continuous positive airway pressure (CPAP) Belly Syndrome in preterm infants in the neonatal intensive care unit (NICU). J Perinatol (2024). https://doi.org/10.1038/s41372-024-01918-2

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