Photo Credit: Brownie Harris

The following is a summary of “Association of a Count of Inpatient Morbidities with Two-Year Outcomes among Infants Born Extremely Preterm,” published in the December 2024 issue of Pediatrics by Dorner et al.  

Researchers conducted a retrospective study to determine if the number of neonatal morbidities is associated with death or severe neurodevelopmental impairment (sNDI) in infants born extremely preterm.  

They analyzed data from 3,794 infants born at 22 to 26 weeks of gestation (2014 and 2019) across 15 centers in the National Institutes of Health (NIH) National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN). Neonatal morbidities and 2-year outcomes were examined among infants who survived to 36 weeks of postmenstrual age (PMA).  

The results showed that severe brain injury (SBI), bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity (ROP) were strongly associated with death or sNDI with ORs of 3.96 (95% CI, 3.39 to 4.64), 3.41 (95% CI, 2.94 to 3.95), and 2.66 (95% CI, 2.28 to 3.11), respectively. A morbidity count variable including these three conditions showed that the odds of death or sNDI increased from 2.75 (95% CI, 2.25 to 3.37) for any 1 morbidity to 6.10 (95% CI, 4.83 to 7.70) for any 2, and 12.90 (95% CI, 9.07 to 18.36) for all 3 morbidities. Rates of late death or sNDI were 12.6% with no morbidities, 30.3% with any 1, 51.9% with any 2, and 69.9% with all 3 morbidities. The logistic model predicted death or sNDI with moderate discrimination (C-statistic [95% CI]: 0.765 [0.749 to 0.782]) and good calibration (intercept [95% CI]: -0.004, slope: 1.026).  

They concluded that a count of serious brain injury, bronchopulmonary dysplasia, and severe retinopathy of prematurity in infants born extremely preterm predicts the likelihood of death or sNDI.  

Source: jpeds.com/article/S0022-3476(24)00531-6/abstract