Perinatal risk-indicators for long-term respiratory morbidity among preterm or very low birth weight neonates

被引:15
作者
Teune, Margreet J. [1 ]
van Wassenaer, Aleid G. [2 ]
van Buuren, Stef
Mol, Ben Willem J. [1 ]
Opmeer, Brent C. [3 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Obstet & Gynaecol, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Emmas Childrens Hosp, Dept Neonatol, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands
关键词
Prematurity; Low birth weight; Long-term respiratory morbidity; Prediction model; GESTATIONAL-AGE INFANTS; PROJECT;
D O I
10.1016/j.ejogrb.2012.04.015
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objectives: To develop prediction models for long-term respiratory morbidity. To explore if respiratory distress syndrome (RDS) is a risk-indicator for long-term respiratory morbidity and to identify other perinatal risk-indicators for long-term respiratory morbidity. Study design: In the Dutch POPS cohort 1338 live born infants delivered in The Netherlands in 1983, either before 32 completed weeks gestation and/or with a birth weight below 1500 g, were followed prospectively. We used multivariable logistic regression analyses to construct three prediction models for respiratory morbidity at 2, 5 and 19 years of age. Results: At 2 years of age, maternal smoking (adjusted OR 1.5, 95% CI 1.0-2.4), prolonged rupture of membranes (adjusted OR 2.3, 95% CI 1.3-4.1), pre-eclampsia (adjusted OR 1.9, 95% CI 1.1-4.1), male gender (adjusted OR 1.5, 95% CI 1.1-2.0) and BPD (adjusted OR 1.9, 95% CI 1.1-3.2) were significantly associated with respiratory morbidity. Prolonged rupture of membranes (adjusted OR 3.7, 95% CI 1.6-8.5), family history of asthma (adjusted OR 5.9, 95% CI2.7-13.0) and BPD (adjusted OR 1.8, 95% CI1.1-3.0) were significantly associated with respiratory morbidity at 5 years of age. At 19 years of age only higher social class was associated with decreased respiratory morbidity (adjusted OR 0.64, 95% CI 0.41-0.99). The areas under the curves (AUC) were 0.65, 0.71 and 0.61 respectively. The prediction models for respiratory morbidity at 2 and 5 years of age showed a good calibration, while the calibration plot for respiratory morbidity at 19 year was less optimal. Conclusions: RDS is not a risk-indicator for long-term respiratory morbidity at 2, 5 and 19 years in this cohort (OR 1.2, 95% 0.88-1.7; 1.3, 95% 0.88-2.0; OR 0.91, 95% 0.56-1.5 respectively). Future obstetric studies interested in the effect of a specific perinatal intervention on long-term respiratory morbidity, should consider taking bronchopulmonary dysplasia (BPD) as primary outcome instead of RDS. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:134 / 141
页数:8
相关论文
共 21 条
[1]  
[Anonymous], 2008, SPSS 17 0 MISS VAL
[2]   BRONCHOPULMONARY DYSPLASIA - CLINICAL PRESENTATION [J].
BANCALARI, E ;
ABDENOUR, GE ;
FELLER, R ;
GANNON, J .
JOURNAL OF PEDIATRICS, 1979, 95 (05) :819-823
[3]  
Bancalari Eduardo, 2003, Semin Neonatol, V8, P63, DOI 10.1016/S1084-2756(02)00192-6
[4]  
Bland R.D., 2000, CHRONIC LUNG DIS EAR
[5]   Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome [J].
Buchanan, Sarah L. ;
Crowther, Caroline A. ;
Levett, Kate M. ;
Middleton, Philippa ;
Morris, Jonathan .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2010, (03)
[6]  
Buuren, 2010, J STAT SOFTWARE, V2010
[7]   Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease (Withdrawn Paper. 2007, art. no. CD003935) [J].
Crowther, C. A. ;
Harding, J. E. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2007, (03)
[8]  
Kloosterman G J, 1969, Ned Tijdschr Verloskd Gynaecol, V69, P349
[9]   Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT) Trial [ISRCTN44485060] [J].
Morris J.M. ;
Roberts C.L. ;
Crowther C.A. ;
Buchanan S.L. ;
Henderson-Smart D.J. ;
Salkeld G. .
BMC Pregnancy and Childbirth, 6 (1)
[10]   Multiple courses of antenatal corticosteroids for preterm birth (MACS): a randomised controlled trial [J].
Murphy, Kellie E. ;
Hannah, Mary E. ;
Willan, Andrew R. ;
Hewson, Sheila A. ;
Ohlsson, Arne ;
Kelly, Edmond N. ;
Matthews, Stephen G. ;
Saigal, Saroj ;
Asztalos, Elizabeth ;
Ross, Susan ;
Delisle, Marie-France ;
Amankwah, Kofi ;
Guselle, Patricia ;
Gafni, Amiram ;
Lee, Shoo K. ;
Armson, B. Anthony .
LANCET, 2008, 372 (9656) :2143-2151