Abnormal Pulmonary Outcomes in Premature Infants: Prediction From Oxygen Requirement in the Neonatal Period

TLDR

The study examined 605 very low birth weight infants with 2‑year follow‑up, identified 119 with abnormal pulmonary outcomes, and compared their neonatal oxygen needs to 486 infants with normal pulmonary function. Oxygen requirement at 28 days yielded only a 38 % PPV for later pulmonary abnormalities, whereas oxygen need at 36 weeks corrected age increased PPV to 63 % and predicted normal outcomes with 90 % accuracy, though predictive power declined with lower gestational age.

Abstract

The follow-up records of 605 infants with birth weights of less than 1,500 g, with data available for 2 years after birth, were examined for evidence of abnormal pulmonary signs or symptoms. A total of 119 infants were identified and the neonatal oxygen requirements of these infants were compared with those of 486 infants who had normal pulmonary function. A requirement for oxygen at 28 days of life had a positive predictive value for abnormal pulmonary findings at the time of follow-up of only 38%, whereas 31% of those with normal pulmonary findings at the time of follow-up were still receiving oxygen at this age. The need for oxygen at 28 days was a good predictor of abnormal findings in infants of ≥3O weeks' gestational age at birth but became increasingly less useful as gestational age decreased It was found that, irrespective of gestational age at birth, the ment for additional oxygen at 36 weeks' corrected postnatal gestational age was a better predictor of abnormal outcome, increasing the positive predictive value to 63%. The prediction of a normal outcome remained 90% for infants not receiving oxygen at this corrected gestational age.