Inpatient morbidities and medical technology use at 2 years among extremely preterm infants.

BACKGROUND: Extremely preterm infants may use medical technology after discharge from neonatal intensive care. The aim of the study was to determine which inpatient morbidities have the strongest associations with technology at toddler-age follow-up. METHODS: Retrospective cohort analysis of 3904 extremely preterm infants born 22.0-26.6 weeks' gestation from 2014 to 2019 who survived to 36 weeks' postmenstrual age and had data on medical technology at 22-26 months' corrected gestational age. RESULTS: 18.8% of children used medical technology; 10.1% used one and 8.7% ≥ 2. Use of a gastrostomy tube was most common (12.8%), followed by pulse oximeter (8.2%), oxygen (5.9%), tracheostomy (3.9%), shunt for hydrocephalus (3.6%), ventilator/continuous positive airway pressure (2.2%), apnea monitor (1.4%), and total parenteral nutrition (0.3%). After adjusting for significant maternal and infant characteristics, Grade 2 or 3 bronchopulmonary dysplasia (BPD) was most strongly associated with medical technology (aOR (95% CI): 3.20 (2.65, 3.87)), followed by serious brain injury (SBI) 3.06 (2.55, 3.66) and surgical NEC (sNEC) 2.67 (1.84, 3.87). CONCLUSIONS AND RELEVANCE: In this cohort of extremely preterm infants, BPD, SBI and sNEC were most associated with medical technology use at toddler-age. These findings provide information for counseling of families and support during discharge planning. GOV ID: Generic Database: NCT00063063. IMPACT: In this cohort of extremely preterm infants <27 weeks' gestation at birth, nearly 1 in 5 children used medical technology at 22-26 months' corrected age. The inpatient morbidities of bronchopulmonary dysplasia, serious brain injury, and surgical necrotizing enterocolitis were most associated with persistent medical technology use. These findings provide important information for counseling families of children with these morbidities during the hospital stay and call for increased support of these families after discharge.

Duke Scholars

Author Monica Elizabeth Lemmon Pediatrics, Neurology

Author Kathryn E. Gustafson Psychiatry, Child & Family Mental Health & Community Psychia ...