Preemies with bronchopulmonary dysplasia: minimal benefit with postdischarge O2

  • Pediatrics

  • International Clinical Digest
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Takeaway

  • In preterm infants with bronchopulmonary dysplasia (BPD), postdischarge oxygen therapy might yield minimal growth improvement at 2 years and increase use of resources but results in no differences in neurodevelopment.

Why this matters

  • BPD incidence is increasing among extremely preterm infants, and one-fourth are discharged with supplemental oxygen, which carries risks with poorly established benefits.
  • Editorial calls the study a “critical service” in terms of forming a basis for prospective trials.

Key results

  • Growth at 2 years: adjusted mean difference in z-score with supplemental oxygen, 0.11 (95% CI, 0.00-0.22).
  • Weight-for-length z-score also suggested improvement with oxygen: adjusted mean difference, 0.13 (95% CI, 0.06-0.20).
  • However, oxygen supplementation was tied to increased adjusted relative risk for rehospitalization for respiratory illness: 1.33 (95% CI, 1.16-1.53).
  • Neurodevelopment was similar with or without supplemental oxygen.

Study design

  • Propensity score matching used for 1039 infants discharged with supplemental oxygen paired 1:1 with infants discharged on room air.
  • Outcomes: growth, neurodevelopment.
  • Funding: NIH.

Limitations

  • Infants with most severe respiratory disease could not be matched and were excluded; results thus might apply only for infants who could be weaned from oxygen supplementation before discharge.

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