Predicting the need for ventilatory support in neonates 30−36 weeks’ gestational age

Patel, Hiren; Beeby, PJ; Dj, Henderson-Smart

doi:10.1046/j.1440-1754.2003.00126.x

Cited by 17 publications

(18 citation statements)

References 18 publications

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“…A major reason for the lower survival rate in our study was the unexpectedly large proportion of infants born prematurely (30%), which is much higher than published rates [11,15]. It is known that respiratory morbidity is increased in infants with increasing prematurity and elective cesarean delivery [16,17]. It is also possible that units with better outcomes might be more likely to participate in the voluntary CDH study group register, which is not population-based.…”

Section: Discussionmentioning

confidence: 65%

A population-based study of congenital diaphragmatic hernia outcome in New South Wales and the Australian Capital Territory, Australia, 1992-2001

Walker

Badawi

Levison

et al. 2006

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 65%

A population-based study of congenital diaphragmatic hernia outcome in New South Wales and the Australian Capital Territory, Australia, 1992-2001

Walker

Badawi

Levison

et al. 2006

Journal of Pediatric Surgery

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“…Although no studies have specifically examined the effects of SHS on newborn infants admitted to the neonatal intensive care unit (NICU), these infants are likely more vulnerable to the effects of SHS than are well babies. Infants in the NICU often require cardiac and pulmonary monitoring with oxygen therapy or mechanical ventilation at some point during their admission (Apisarnthanarak, Holzmann-Pazgal, Hamvas, Olsen, & Fraser, 2003;Patel, Beeby, & Henderson-Smart, 2003). The prevalence of underlying chronic pulmonary disease including bronchopulmonary dysplasia, apnea, and reactive airway disease in NICU infants reaches 20% (Manktelow, Draper, Annamalai, & Field, 2001;Schraeder, Czajka, Kalman, & McGeady, 1998).…”

Section: Introductionmentioning

confidence: 99%

Smoking behavior and risk perception among the parents of infants in the neonatal intensive care unit

Bock

Becker

Borrelli

2008

CNTR

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The goal of this study was to explore the prevalence of smoking and attitudes and behaviors relevant to smoking cessation among parents of babies treated in a neonatal intensive care unit (NICU). Participants were 235 mothers and 83 fathers of infants admitted to the NICU of a large, university-based hospital. The 38-item survey included questions that assessed smoking status (current, former, never-smoker), motivation to quit, perceived health risks from smoking, and whether or not they received smoking cessation advice or counseling from a health care provider. A total of 26% of all participants were current smokers. Compared with mothers, fathers were more likely to be current smokers (22% vs. 31%) and smoked more cigarettes per day (11.3% vs. 17.2%). Among participants, 57% reported that smoking affected their own health "a little" or "not at all," and 70% believed that others' smoking would affect the baby's health "a little" or "somewhat." Mothers were more likely than fathers to report health care provider intervention for smoking cessation. Indeed, none of the fathers in this study reported being offered assistance with quitting smoking. More than half of smokers were willing to receive counseling for smoking cessation, and health care provider intervention was positively associated with both motivation to quit and perceived health risk to their infant (p<.01). The NICU may provide a teachable moment in which parents can be assisted with quitting smoking, thus improving their own health and the health of their babies.

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“…7 The overall premature birth rate was 12.8% in 2006, which includes a higher proportion in children with CDH. 8–10 Levison et al 11 found a 30% incidence of prematurity in infants with CDH with a nearly 50% decrease in survival, compared with term infants with CDH (35% vs 64%, respectively; unadjusted odds ratio [OR], 3.45; 95% confidence interval [CI], 1.83–6.50).…”

mentioning

confidence: 99%

Congenital diaphragmatic hernia in the preterm infant

Tsao

Allison

Harting

et al. 2010

Surgery

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Background Congenital diaphragmatic hernia (CDH) remains a significant cause of death in newborns. With advances in neonatal critical care and ventilation strategies, survival in the term infant now exceeds 80% in some centers. Although prematurity is a significant risk factor for morbidity and mortality in most neonatal diseases, its associated risk with infants with CDH has been described poorly. We sought to determine the impact of prematurity on survival using data from the Congenital Diaphragmatic Hernia Registry (CDHR). Methods Prospectively collected data from live-born infants with CDH were analyzed from the CDHR from January 1995 to July 2009. Preterm infants were defined as <37 weeks estimated gestational age at birth. Univariate and multivariate logistic regression analysis were performed. Results During the study period, 5,069 infants with CDH were entered in the registry. Of the 5,022 infants with gestational age data, there were 3,895 term infants (77.6%) and 1,127 preterm infants (22.4%). Overall survival was 68.7%. A higher percentage of term infants were treated with extracorporeal membrane oxygenation (ECMO) (33% term vs 25.6% preterm). Preterm infants had a greater percentage of chromosomal abnormalities (4% term vs 8.1% preterm) and major cardiac anomalies (6.1% term vs 11.8% preterm). Also, a significantly higher percentage of term infants had repair of the hernia (86.3% term vs 69.4% preterm). Survival for infants that underwent repair was high in both groups (84.6% term vs 77.2% preterm). Survival decreased with decreasing gestational age (73.1% term vs 53.5% preterm). The odds ratio (OR) for death among preterm infants adjusted for patch repair, ECMO, chromosomal abnormalities, and major cardiac anomalies was OR 1.68 (95% confidence interval [CI], 1.34–2.11). Conclusion Although outcomes for preterm infants are clearly worse than in the term infant, more than 50% of preterm infants still survived. Preterm infants with CDH remain a high-risk group. Although ECMO may be of limited value in the extremely premature infant with CDH, most preterm infants that live to undergo repair will survive. Prematurity should not be an independent factor in the treatment strategies of infants with CDH.

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Predicting the need for ventilatory support in neonates 30−36 weeks’ gestational age

Cited by 17 publications

References 18 publications

A population-based study of congenital diaphragmatic hernia outcome in New South Wales and the Australian Capital Territory, Australia, 1992-2001

A population-based study of congenital diaphragmatic hernia outcome in New South Wales and the Australian Capital Territory, Australia, 1992-2001

Smoking behavior and risk perception among the parents of infants in the neonatal intensive care unit

Congenital diaphragmatic hernia in the preterm infant

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