Journal Article

Neurodevelopmental outcomes of preterm neonates receiving rescue inhaled nitric oxide in the first week of age: a cohort study

Banihani, Rudaina, Shafey, Amy, Bodani, Jaya, Lemyre, Brigitte, Gurram Venkata, Sujith Kumar Reddy, Metcalfe, Amy, Melamed, Nir, Silva, Orlando Da, Pillay, Thevanisha, Lodha, Abhay, Nguyen, Kim-Anh, Louis, Deepak, Taillefer, Catherine, Makary, Hala, Ojah, Cecil, Kanungo, Jaideep, Newman, Alana, Drolet, Christine, McKnight, Sarah, Kajetanowicz, Andrzej, Oliveira, Caio Barbosa de, Bélanger, Sylvie, Allen, Vicky, VanDyk, Jessie, Yi, Ann, Wood, Stephen, Reichert, Amber, Jain, Amish, Luu, Thuy Mai, Sherlock, Rebecca, Dahlgren, Leanne, Wong, Jonathan, Daboval, Thierry, Mukerji, Amit, Taboun, Fatima, Boucoiran, Isabelle, Gratton, Rob, Hicks, Matthew, Beltempo, Marc, Masse, Edith, Lee, Kyong-Soon, Piedboeuf, Bruno, Abenhaim, Haim, Barrington, Keith, St-Hilaire, Marie, Augustine, Sajit, Ethier, Guillaume, Fajardo, Carlos, Wou, Karen, Mehrem, Ayman Abou, Bizgu, Victoria, Toye, Jennifer, Shah, Prakesh S, Helewa, Michael, Claveau, Martine, Ye, Xiang, Benlamri, Amina, Ly, Linh, Coughlin, Kevin, Morin, Alyssa, Cabo, Cecilia de, Thomas, Karen, Raghuram, Kamini, Seesahai, Judy, Moddemann, Diane, Hendson, Leonora, Ng, Eugene, Soraish

2024

Overview

ObjectiveTo assess the neurodevelopmental outcomes of preterm neonates who received inhaled nitric oxide (iNO) in the first week of age for hypoxaemic respiratory failure (HRF).MethodsIn this retrospective cohort study, we included neonates born at <29 weeks gestational age (GA) between January 2010 and December 2018 who had a neurodevelopmental assessment at 18–24 months corrected age (CA) at one of the Canadian Neonatal Follow-Up Network clinics. The primary outcome was neurodevelopmental impairment (NDI). We performed propensity score-matched analysis to compare the outcomes of those who received and did not receive iNO.ResultsOf the 5612 eligible neonates, 460 (8.2%) received iNO in the first week of age. Maternal age, receipt of antenatal corticosteroids, GA and birth weight were lower in the iNO group compared with the no-iNO group. Neonates in the iNO group had higher illness severity scores and higher rates of preterm prolonged rupture of membranes and were small for GA. Severe brain injury, bronchopulmonary dysplasia and mortality were higher in the iNO group. Of the 4889 survivors, 3754 (77%) neonates had follow-up data at 18–24 months CA. After propensity score matching, surviving infants who received rescue iNO were not associated with higher odds of NDI (adjusted OR 1.34; 95% CI 0.85 to 2.12).ConclusionsIn preterm neonates <29 weeks GA with HRF, rescue iNO use was not associated with worse neurodevelopmental outcomes among survivors who were assessed at 18–24 months CA.

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD
• Subject: Administration, Inhalation / Canada - epidemiology / Cerebral palsy / Cohort analysis / Cohort Studies / Corticoids / Data collection / Female / Gestational age / Humans / Infant / infant development / Infant, Newborn / Infant, Premature / Infant, Premature, Diseases - drug therapy / Intensive care / intensive care units, neonatal / Mortality / Neonates / neonatology / Neurodevelopmental Disorders - epidemiology / Newborn babies / Nitric oxide / Nitric Oxide - administration & dosage / Original research / paediatrics / Pediatrics / Pregnancy / Premature babies / Premature birth / Regression analysis / Research ethics / Respiratory distress syndrome / Respiratory failure / Respiratory Insufficiency / Retrospective Studies / Treatment Outcome / Visual impairment