与表面活性剂相关的结局在更成熟和更大的患有呼吸窘迫综合征的早产儿中。
Outcomes associated with surfactant in more mature and larger premature infants with respiratory distress syndrome.
机构信息
Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, 101 Manning Drive, Room N4051, CB #7596, Chapel Hill, NC, 27599, USA.
Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
出版信息
J Perinatol. 2020 Aug;40(8):1171-1177. doi: 10.1038/s41372-020-0625-1. Epub 2020 Feb 20.
OBJECTIVE
Examine the effect of off-label surfactant on mortality and morbidity in more mature and larger premature infants diagnosed with respiratory distress syndrome (RDS).
STUDY DESIGN
Cohort study of premature infants born at 30-36 weeks, birth weight > 2 kg, and a diagnosis of RDS. We compared the odds of mortality and morbidity between infants who were exposed vs unexposed to surfactant. We used a treatment effects model to balance covariates between groups.
RESULTS
Of 54,964 included infants, 25,278 (46%) were exposed to surfactant. The frequency of mortality and morbidities were higher in the exposed group in unadjusted analyses. Following adjustment with a doubly robust treatment effects model, we found no significant treatment effect of surfactant on mortality or morbidity.
CONCLUSION
Surfactant exposure is not associated with reduced or increased mortality or morbidity in more mature premature infants with RDS.
目的
研究在诊断为呼吸窘迫综合征（RDS）的更成熟和更大胎龄的早产儿中，使用超说明书表面活性剂对死亡率和发病率的影响。
研究设计
这是一项对胎龄为 30-36 周、出生体重＞2kg 且患有 RDS 的早产儿进行的队列研究。我们比较了接受和未接受表面活性剂治疗的婴儿的死亡率和发病率的比值。我们使用治疗效果模型来平衡组间的协变量。
结果
在纳入的 54964 名婴儿中，有 25278 名（46%）接受了表面活性剂治疗。在未调整的分析中，暴露组的死亡率和发病率更高。在用双重稳健的治疗效果模型进行调整后，我们发现表面活性剂对死亡率或发病率没有显著的治疗效果。
结论
在患有 RDS 的更成熟早产儿中，使用表面活性剂并不能降低或增加死亡率或发病率。
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