Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Janeway Children's Health and Rehabilitation Centre, Saint John's, Newfoundland, Canada.
Am J Perinatol. 2018 Aug;35(10):972-978. doi: 10.1055/s-0038-1632390. Epub 2018 Feb 23.
The objective is to evaluate the association between antibiotic utilization and neurodevelopmental outcomes at 18 to 21 months' corrected age among extremely low gestational age neonates without culture-proven sepsis or necrotizing enterocolitis (NEC).
We conducted a retrospective cohort study of infants born between April 2009 and September 2011 at <29 weeks' gestation and admitted to the neonatal intensive care units contributing data to the Canadian Neonatal Network. Multivariable analysis was performed to examine the primary composite outcome of death or significant neurodevelopmental impairment (sNDI) in infants with various antibiotic utilization rates (AURs).
There were 1,373 infants who fulfilled our inclusion criteria. Compared with infants in the lowest AUR quartile (Q1), those in the highest quartile (Q4) had higher odds of death or sNDI (adjusted odds ratio [AOR] = 7.44; 95% confidence interval [CI]: 4.55, 12.2) and death (AOR = 39.3; 95% CI: 16.1, 95.9).
Our results indicate an association between high AUR and a composite outcome of death or adverse neurodevelopmental outcomes at 18 to 21 months' corrected age.
评估无培养证实的败血症或坏死性小肠结肠炎（NEC）的极低出生体重儿在纠正胎龄 18 至 21 个月时抗生素使用与神经发育结局之间的关联。
我们进行了一项回顾性队列研究，纳入 2009 年 4 月至 2011 年 9 月期间出生、胎龄<29 周且入组加拿大新生儿网络数据贡献单位新生儿重症监护病房的婴儿。采用多变量分析方法，检查不同抗生素使用率（AUR）婴儿的主要复合结局（死亡或显著神经发育障碍（sNDI））。
共有 1373 名符合纳入标准的婴儿。与 AUR 最低四分位（Q1）的婴儿相比，AUR 最高四分位（Q4）的婴儿死亡或 sNDI（调整后的优势比[OR] = 7.44；95%置信区间[CI]：4.55，12.2）和死亡（OR = 39.3；95% CI：16.1，95.9）的风险更高。
我们的结果表明，高 AUR 与纠正胎龄 18 至 21 个月时死亡或不良神经发育结局的复合结局之间存在关联。
