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Long-term outcome of preterm infants treated with nasal continuous positive airway pressure

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Abstract

This study’s aim was to assess neurodevelopmental and growth outcome until the age of 4 years of premature infants placed on early nCPAP, in the setting of the neonatal intensive care unit (NICU) and follow-up program of the Division of Neonatology of the Department of Pediatrics of the University Hospital, Lausanne, Switzerland. All consecutive inborn infants weighing <1500 g or <32 weeks of gestational age admitted to the NICU during two periods of 12 months—7.1996–6.1997 and 7.1998–6.1999—were compared before and after the systematic application of early nCPAP. Of 172 infants admitted to the NICU, 150 (87%) survived. 126 (84%) were tested at 6 months’ corrected age, 121 (81%) at 18 months’ corrected age, and 117 (78%) at the age of 4 years. Detailed perinatal data were collected. Follow-up included neurological examination, developmental testing and measurement of growth parameters. Statistical analyses were performed. Early application of nCPAP and avoidance of mechanical ventilation showed no adverse effects on neurodevelopment and growth. A significantly higher developmental quotient was found in the nCPAP group at 18 months’ corrected age. Several trends were also noted in the nCPAP group with a decrease of intraventricular hemorrhage and in “abnormal neurodevelopment” at 6 months corrected age, a bigger head circumference at all different tested ages and a greater height at 6 and 18 months corrected ages. In conclusion, our study of developmental outcome documents the absence of any harmful effect of early application of nCPAP to treat respiratory failure in very low birthweight infants.

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Abbreviations

nCPAP:

nasal continuous positive airway pressure

VLBW:

very low birth weight

DQ:

developmental quotient

GII:

general intellectual index

NBRS:

neurobiological risk score

IVH:

intraventricular hemorrhage

PVL:

periventricular leukomalacia

ROP:

retinopathy of prematurity

AER:

auditory evoked responses

DQ:

developmental quotient

GII:

general intellectual index

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Acknowledgments

The authors thank Dr Jean-Leopold Micheli for his scientific advice and support, and the families and infants of the cohorts.

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Authors and Affiliations

  1. Developmental Unit, Division of Neonatology, Department of Pediatrics, University Hospital (CHUV) and Lausanne Medical School, 1011, Lausanne, Switzerland

    Pia Wintermark, Jean-François Tolsa, Margarita Forcada-Guex & Adrien C. Moessinger

  2. Biostatistics Unit, Institute of Social and Preventive Medicine, University Hospital (CHUV) and Lausanne Medical School, 1011, Lausanne, Switzerland

    Guy Van Melle

Authors
  1. Pia Wintermark
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  2. Jean-François Tolsa
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  3. Guy Van Melle
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  4. Margarita Forcada-Guex
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  5. Adrien C. Moessinger
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Correspondence to Pia Wintermark.

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Wintermark, P., Tolsa, JF., Van Melle, G. et al. Long-term outcome of preterm infants treated with nasal continuous positive airway pressure. Eur J Pediatr 166, 473–483 (2007). https://doi.org/10.1007/s00431-006-0272-3

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  • DOI: https://doi.org/10.1007/s00431-006-0272-3

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