Project Engineer TC Energy Calgary, Alberta, Canada
Background: Pneumothorax (PTX) is not an uncommon acute event in preterm infants, associated with hypoxemia, hypercapnia, hemodynamic instability and respiratory deterioration. There is no data on neurodevelopmental (ND) outcomes of preterm infants with PTX.
Objective: To determine ND outcomes at 18-21 months of corrected age for infants < 29 weeks gestation who develop PTX compared to those who do not.
Design/Methods: Using the Canadian Neonatal Network and Canadian Follow Up Network databases we investigated the outcomes of infants < 29 weeks gestation with a PTX who were admitted to Canadian NICUs from 2010 to 2017. Infants with major congenital anomalies, moribund/palliative infants and those lost to follow up were excluded. Data from ND assessment conducted using Bayley III and clinical assessment were obtained from 11 units with >70% ND follow up rates. The primary outcome was a composite of death or ND impairment (NDI) defined as any of the following: cerebral palsy (CP) with gross motor function classification system (GMCFS) ≥ 1, Bayley III Motor/ Cognitive/ Language Composite < 85, sensorineural/mixed hearing loss, uni or bilateral visual impairment. Adjusted odds ratio’s (aORs) and 95% confidence interval (CI) were calculated using univariate and multivariate regression analysis.
Results: Of the 4587 eligible infants. 268 had pneumothorax (Figure). 951 infants were lost to follow up (20%) Baseline characteristics are reported in Table1. Rates, unadjusted and adjusted ORs for neonatal outcomes are reported in Table 2. There were higher odds of bronchopulmonary dysplasia and sever neurologic injury prior to discharge in infants with PTX. Neurodevelopmental outcomes are reported in Table 3. There was no difference in the primary outcome of death or NDI at 18-21 months of corrected age between the two groups. In the group with PTX, there was no difference between infants who received a chest tube compared to infants who did not. Conclusion(s): Presence of pneumothorax was not associated with death or NDI in this cohort. This is the first study to report on neurodevelopmental outcomes of infants with PTX. Our data can be used to counsel parents.
Authors/Institutions: Evelyn Armour, TC Energy, Calgary, Alberta, Canada; Anne Synnes, BC Women's Hospital, Vancouver, British Columbia, Canada; Belal Alshaikh, University of Calgary, Calgary, Alberta, Canada; Shabih U. Hasan, University of Calgary, Calgary, Alberta, Canada; Carlos Fajardo, University of Calgary, Calgary, Alberta, Canada; Abhay Lodha, University of Calgary, Calgary, Alberta, Canada; Edith Massé, Centre Intégré universitaire de santé et de service sociaux de l'Estrie- Centre hospitalier universitaire de Sherbrooke (CIUSSSE-CHUS), Sherbrooke, Quebec, Canada; Prakeshkumar Shah, University of Toronto, Toronto, Ontario, Canada; Kamran Yusuf, University of Calgary, Calgary, Alberta, Canada
