极早产儿早期吸氧和间歇性低氧事件与 2 岁时使用哮喘药物有关。
Early inspired oxygen and intermittent hypoxemic events in extremely premature infants are associated with asthma medication use at 2 years of age.
机构信息
Division of Neonatology, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
Division of Neonatology, Golisano Children's Hospital, University of Rochester, Rochester, NY, USA.
出版信息
J Perinatol. 2019 Feb;39(2):203-211. doi: 10.1038/s41372-018-0264-y. Epub 2018 Oct 26.
OBJECTIVE
Extremely premature infants are at risk for childhood wheezing. Early respiratory support and intermittent hypoxemia (IH) events may be associated with adverse breathing outcomes.
STUDY DESIGN
A single-center retrospective cohort study of 137 premature infants <28 weeks gestational age characterized the associations of cumulative oxygen, cumulative mean airway pressure, IH, and oxygen saturation (SpO) on the primary outcome of prescription asthma medication use at 2-year follow-up. Relative risk was calculated by generalized estimating equations.
RESULTS
Reported asthma medication use was 46%. At 1-3 days of age, elevated cumulative oxygen exposure, increased daily IH, and lower mean SpO (adjusted for gestational age and sex) and increased cumulative mean airway pressure exposure (unadjusted) were associated with asthma medication use.
CONCLUSION
Increased oxygen and frequent IH events during just the first 3 days of age may help identify extremely premature newborns at risk for symptomatic childhood wheezing requiring prescription asthma medications.
目的
极早产儿有发生儿童喘息的风险。早期呼吸支持和间歇性低氧血症（IH）事件可能与不良呼吸结局相关。
研究设计
对 137 名胎龄<28 周的早产儿进行了一项单中心回顾性队列研究，研究了累积氧、平均气道压力、IH 和氧饱和度（SpO2）与 2 年随访时使用处方哮喘药物的主要结局之间的关联。通过广义估计方程计算相对风险。
结果
报告的哮喘药物使用率为 46%。在 1-3 天龄时，累积氧暴露增加、每日 IH 增加、平均 SpO2 降低（按胎龄和性别调整）以及累积平均气道压力暴露增加（未调整）与哮喘药物使用相关。
结论
在生命最初的 3 天内，增加的氧气和频繁的 IH 事件可能有助于识别有症状的儿童喘息风险的极早产儿，这些儿童需要使用处方哮喘药物。
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