Association between Pneumothorax and Neonatal Outcomes among Very Preterm Infants: A Multicenter Cohort Study.

IF 3
Neonatology Pub Date : 2025-05-16 DOI:10.1159/000546364
Mengya Sun, Hong Jiang, Liang Zhao, Yun Cao, Lin Yuan, Liyuan Hu, Shoo K Lee, Lizhong Du, Jie Yang, Xianghong Li
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Abstract

Introduction: We aimed to evaluate whether the incidence of pneumothorax is associated with adverse neonatal outcomes in very preterm infants.

Methods: This multicenter cohort study included all infants with a gestational age of 24-31 weeks, admitted to the tertiary neonatal intensive care units of the Chinese Neonatal Network, from 2019 to 2022. Pneumothorax was diagnosed via chest X-ray or lung computed tomography. The primary outcome was a composite measure of mortality and/or any severe neonatal morbidity. Multivariable logistic or linear regression analyses were performed to assess the association between pneumothorax and neonatal outcomes. Propensity score matching was used to ensure the robustness of the results.

Results: Among the 37,917 infants in the study, 465 (1.2%) developed pneumothorax. Pneumothorax was significantly associated with a higher risk of mortality and/or severe neonatal morbidity (adjusted odds ratio = 3.15, 95% confidence interval: 2.36, 4.20). Pneumothorax exposure was also independently associated with increased mortality, severe intraventricular hemorrhage, moderate or severe bronchopulmonary dysplasia, and the need for invasive ventilation and its duration. Additionally, pneumothorax was associated with an increased length of hospital stay among survivors (adjusted odds ratio = 7.62, 95% confidence interval: 4.33, 10.91). The usage of high-frequency invasive mechanical ventilation before pneumothorax and pneumothorax treated with an intercostal chest drain seemed to have the most significant harmful effect (adjusted odds ratios were 3.34 and 3.27, respectively).

Conclusion: Our study underscores the significant impact of pneumothorax on increasing mortality and severe morbidities in very preterm infants.

极早产儿气胸与新生儿结局的关系:一项多中心队列研究。
简介:我们的目的是评估气胸的发生率是否与极早产儿的不良新生儿结局有关。方法:本多中心队列研究纳入2019 - 2022年中国新生儿网三级新生儿重症监护室收治的所有胎龄在24 ~ 31周的新生儿。气胸是通过胸部x线或肺部计算机断层扫描诊断的。主要结局是死亡率和/或任何严重新生儿发病率的综合测量。采用多变量logistic或线性回归分析来评估气胸与新生儿结局之间的关系。使用倾向评分匹配来确保结果的稳健性。结果:在研究的37,917名婴儿中,465名(1.2%)发生气胸。气胸与较高的死亡率和/或严重新生儿发病率显著相关(校正优势比= 3.15,95%可信区间:2.36,4.20)。气胸暴露也与死亡率增加、严重脑室内出血、中度或重度支气管肺发育不良、需要有创通气及其持续时间独立相关。此外,气胸与幸存者住院时间的增加有关(调整优势比= 7.62,95%可信区间:4.33,10.91)。气胸前使用高频有创机械通气和肋间胸腔引流对气胸的有害影响最为显著(校正优势比分别为3.34和3.27)。结论:我们的研究强调了气胸对极早产儿死亡率和严重发病率的显著影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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