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Oxygen desaturations in the early neonatal period predict development of bronchopulmonary dysplasia.

ABSTRACT: BACKGROUND:Bradycardia and oxygen desaturation episodes are common among preterm very low birth weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU), and their association with adverse outcomes such as bronchopulmonary dysplasia (BPD) is unclear. METHODS:For 502 VLBW infants we quantified bradycardias (HR?

SUBMITTER: Fairchild KD

PROVIDER: S-EPMC6488465 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Oxygen desaturations in the early neonatal period predict development of bronchopulmonary dysplasia.

Fairchild Karen D KD Nagraj V Peter VP Sullivan Brynne A BA Moorman J Randall JR Lake Douglas E DE

Pediatric research 20181029 7

<h4>Background</h4>Bradycardia and oxygen desaturation episodes are common among preterm very low birth weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU), and their association with adverse outcomes such as bronchopulmonary dysplasia (BPD) is unclear.<h4>Methods</h4>For 502 VLBW infants we quantified bradycardias (HR < 100 for ≥ 4 s) and desaturations (SpO<sub>2</sub> < 80% for ≥ 10 s), combined bradycardia and desaturation (BD) events, and percent time in events in the first 4 we ...[more]

PMID: 30374050

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Project description:ObjectiveBronchopulmonary dysplasia (BPD) is a serious yet common morbidity of preterm birth. Although prior work suggests a possible role for phthalate exposure in the development of BPD, no study has rigorously evaluated this. Our objective was to determine whether hospital-based phthalate exposure is associated with the development of BPD and to identify developmental windows sensitive to exposure.Study designThis is a prospective multicenter cohort study of 360 preterm infants born at 23-33 weeks gestation participating in the Developmental Impact of NICU Exposures (DINE) cohort. 939 urine specimens collected during the NICU stay were analyzed for biomarkers of phthalate exposure by liquid chromatography with tandem mass spectrometry. The modified Shennan definition was used to diagnose bronchopulmonary dysplasia. Reverse distributed-lag modeling identified developmental windows sensitive to specific phthalate exposure, controlling for relevant covariates including sex and respiratory support.ResultsThirty-five percent of participants were diagnosed with BPD. Exposure to specific phthalate mixtures at susceptible points in preterm infant development are associated with later diagnosis of BPD in models adjusted for use of respiratory support. The weighted influence of specific phthalate metabolites in the mixtures varied by sex. Metabolites of di(2-ethylhexyl) phthalate, a phthalate previously linked to neonatal respiratory support equipment, drove this association, particularly among female infants, at 26- to 30-weeks post-menstrual age.ConclusionsThis is the largest and only multi-site study of NICU-based phthalate exposure and clinical impact yet reported. In well-constructed models accounting for infant sex and respiratory support, we found a significant positive association between ultimate diagnosis of BPD and prior exposure to phthalate mixtures with DEHP predominance at 26- to 30-weeks PMA or 34-36-weeks PMA. This information is critically important as it identifies a previously unrecognized and modifiable contributing factor to BPD.

Dataset Information

Oxygen desaturations in the early neonatal period predict development of bronchopulmonary dysplasia.

Publications

Oxygen desaturations in the early neonatal period predict development of bronchopulmonary dysplasia.

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