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Duration of noninvasive respiratory support and risk for bronchopulmonary dysplasia or death

Journal of Perinatology volume 42, pages 454–460 (2022)Cite this article

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A Correction to this article was published on 21 March 2022

This article has been updated

Abstract

Objective

To determine whether the duration of noninvasive respiratory support exposure is associated with bronchopulmonary dysplasia (BPD) or death in preterm infants.

Methods

Multicenter, retrospective study of infants born at <29 weeks’ gestation. The association between days on noninvasive respiratory support and BPD or death was determined using instrumental variable techniques and generalized propensity score matching to account for potential confounding by illness severity.

Results

Among 6268 infants 36% developed BPD or died. The median duration of noninvasive respiratory support was 18 days. There was inconsistency in the association between noninvasive support and BPD or death when analyzed by instrumental variable techniques (Average Marginal Effect −0.37; 95% CI −1.23 to 0.50) and generalized propensity score matching (Average Marginal Effect 0.46; 95% CI 0.33 to 0.60).

Conclusion

Findings on the association between duration of exposure to noninvasive respiratory support and the development of BPD or death were inconclusive.

ClinicalTrials.gov ID

Generic Database:NCT00063063.

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Fig. 1: Percentage of days on non-invasive support and death or BPD.

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Acknowledgements

The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Center for Advancing Translational Sciences provided grant support for the Neonatal Research Network’s Generic Database Study. While NICHD staff had input into the study design, conduct, analysis, and manuscript drafting, the comments and views of the authors do not necessarily represent the views of NICHD, the National Institutes of Health, the Department of Health and Human Services, or the U.S. Government. Participating NRN sites collected data and transmitted it to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, RTI International had full access to all of the data in the study, and with the NRN Center Principal Investigators, takes responsibility for the integrity of the data and accuracy of the data analysis. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. Additional investigators, in addition to those listed as authors, can be found in the Supplement.

Funding

The National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD100917-01, UG1 HD27904, UG1 HD21364, UG1 HD68284, UG1 HD27853, UG1 HD40492, UG1 HD27851, UG1 HD27856, UG1 HD68278, UG1 HD36790, UG1 HD27880, UG1 HD34216, UG1 HD68270, UG1 HD53109, UG1 HD53089, UG1 HD68244, UG1 HD68263, UG1 HD40689, UG1 HD21385, UG1 HD87226, UG1 HD87229), and the National Center for Advancing Translational Sciences (UL1 TR105, UL1 TR1425, UL1 TR1117, UL1 TR454, UL1 TR1108, UL1 TR1085, UL1 TR442, UL1 TR1449, UL1 TR42) provided grant support for the Neonatal Research Network. Although the National Institute of Child Health and Human Development staff did have input into the study design, conduct, analysis, and manuscript drafting, the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA

    Samuel J. Gentle, Colm P. Travers, Namasivayam Ambalavanan, Charitharth V. Lal & Waldemar A. Carlo

  2. Statistics and Epidemiology Unit, RTI International, Research Triangle, NC, USA

    Benjamin Carper & Austin Williams

  3. Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA

    Matthew M. Laughon

  4. Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Erik A. Jensen

Authors
  1. Samuel J. Gentle
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  2. Benjamin Carper
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  3. Matthew M. Laughon
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  4. Erik A. Jensen
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  5. Austin Williams
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  6. Colm P. Travers
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  7. Namasivayam Ambalavanan
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  8. Charitharth V. Lal
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  9. Waldemar A. Carlo
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Contributions

Samuel J. Gentle conceptualized and implemented this study, performed initial analyses, drafted the manuscript, and reviewed and revised the manuscript. Benjamin Carper conceptualized the study, conducted the statistical analyses, and reviewed and revised the manuscript. Matthew M Laughon assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. Erik A Jensen assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. Austin Williams conducted the statistical analyses, assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. Colm P Travers assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. Namasivayam Ambalavanan assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. Charitharth V Lal assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. Waldemar A. Carlo assisted with analyses, conceptualization of the study, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Samuel J. Gentle.

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The authors declare no competing interests.

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The original online version of this article was revised: The author group and acknowledgements has been changed. In addition, the list of authors of the consortium has been included as Supplementary Information.

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Gentle, S.J., Carper, B., Laughon, M.M. et al. Duration of noninvasive respiratory support and risk for bronchopulmonary dysplasia or death. J Perinatol 42, 454–460 (2022). https://doi.org/10.1038/s41372-021-01269-2

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