Association Between Intermittent Hypoxemia or Bradycardia and Late Death or Disability in Extremely Preterm Infants

摘要: Importance Extremely preterm infants may experience intermittent hypoxemia or bradycardia for many weeks after birth. The prognosis of these events is uncertain. Objective To determine the association between and late death disability. Design, Setting, Participants Post hoc analysis data from inception cohort assembled Canadian Oxygen Trial in 25 hospitals Canada, United States, Argentina, Finland, Germany, Israel, including 1019 with gestational ages 23 0 days through 27 6 who were born December 2006 August 2010 survived to a postmenstrual age 36 weeks. Follow-up assessments occurred October 2008 2012. Exposures Episodes (pulse oximeter oxygen saturation Main Outcomes Measures primary outcome was composite weeks’ age, motor impairment, cognitive language delay, severe hearing loss, bilateral blindness at 18 months’ corrected age. Secondary outcomes retinopathy prematurity. Results Downloaded pulse rate available median 68.3 (interquartile range, 56.8-86.0 days). Mean percentages recorded time least most affected 10% 0.4% 13.5%, respectively. Corresponding values 0.1% 0.3%. ascertained 972 present 414 (42.6%). Hypoxemic episodes associated an estimated increased risk disability months 56.5% highest decile hypoxemic exposure vs 36.9% lowest (modeled relative risk, 1.53; 95% CI, 1.21-1.94). This significant only prolonged lasting 1 minute (relative 1.66; 1.35-2.05 shorter episodes, 1.01; 0.77-1.32). Relative risks all secondary similarly hypoxemia. Bradycardia did not alter prognostic value Conclusions Relevance Among extremely during first 2 3 birth adverse 18-month outcomes. If confirmed future studies, further research on prevention such needed.