scholarly journals Extreme Prematurity and Pulmonary Outcomes Program in Saitama (EPOPS): A Study Protocol of a Prospective Multicenter Cohort Study of Extremely Preterm Infants in Japan (Preprint)

2020 ◽  
Author(s):  
Fumihiko Namba ◽  
Kosuke Tanaka ◽  
Sayu Omori ◽  
Kazushige Ikeda ◽  
Ken Kawabata ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Developed Countries ◽  
Respiratory Morbidity ◽  
Extreme Prematurity ◽  
Multicenter Cohort Study ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Definition Of

UNSTRUCTURED Introduction: Because of the improvements in survival rates for preterm infants, not only the rates of bronchopulmonary dysplasia (BPD) but also that of long-term respiratory complications of premature birth are increasing, which results in financial and health burdens in developed countries. Thus far, risk factors of respiratory morbidities of extremely preterm infants remain unknown. Furthermore, the definition, as well as the predictive ability, of BPD for long-term respiratory outcomes are yet to be determined. Therefore, Extreme Prematurity and Pulmonary Outcomes Program in Saitama (EPOPS) aims to develop the diagnostic criteria for BPD and to determine the prognostic factors contributing to the long-term pulmonary outcomes manifested in extremely preterm infants. Methods and analysis: The EPOPS is an observational prospective cohort study performed by a consortium of six neonatal intensive care units (NICUs) in Saitama, Japan. The subjects included in this study were infants (from each clinical center) with gestational ages 22 to 27 weeks, having an expected target of 400 subjects. This study aims to determine the definition of BPD and other perinatal factors which accurately predict the long-term pulmonary outcomes in survivors of extreme prematurity. Moreover, association between BPD and post-prematurity respiratory disease (PRD) will also be investigated using generalized linear models. Discussion: The EPOPS incorporates the aspects of neonatal care in secondary- and tertiary-level NICUs to develop the existing research studies on the definition of BPD, objective biomarkers, and outcome measures of respiratory morbidity in extremely preterm infants beyond the NICU hospitalization, thereby leading to a novel understanding of the nature and natural history of BPD and of potential mechanistic and therapeutic targets among at-risk subjects. Ethics and Dissemination: The protocol and consent forms were evaluated and approved by institutional review boards at each EPOPS center. Registration details: Not registered because of an observational study without any interventions.

Early inhaled budesonide in extremely preterm infants decreases long‐term respiratory morbidity

2020 ◽  
Vol 55 (5) ◽  
pp. 1124-1130 ◽  
Author(s):  
Jana Tukova ◽  
Jan Smisek ◽  
Blanka Zlatohlavkova ◽  
Richard Plavka ◽  
Daniela Markova
Keyword(s):  
Preterm Infants ◽  
Respiratory Morbidity ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Inhaled Budesonide

scholarly journals Patterns of reintubation in extremely preterm infants: a longitudinal cohort study

2018 ◽  
Vol 83 (5) ◽  
pp. 969-975 ◽  
Author(s):  
Wissam Shalish ◽  
Lara Kanbar ◽  
Martin Keszler ◽  
Sanjay Chawla ◽  
Lajos Kovacs ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Factors associated with long-term mechanical ventilation in extremely preterm infants

2018 ◽  
Vol 11 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Lina Yossef ◽  
Edward G. Shepherd ◽  
Susan Lynch ◽  
Kristina M. Reber ◽  
Leif D. Nelin
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Factors Associated ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Short- and Long-Term Outcomes of Extremely Preterm Infants in Japan According to Outborn/Inborn Birth Status*

2019 ◽  
Vol 20 (10) ◽  
pp. 963-969 ◽  
Author(s):  
Yoshihito Sasaki ◽  
Kaoru Ishikawa ◽  
Akira Yokoi ◽  
Tomoaki Ikeda ◽  
Kazuo Sengoku ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Long Term Outcomes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Short And Long Term

Persistent pulmonary hypertension of the newborn in extremely preterm infants: a Japanese cohort study

2018 ◽  
Vol 103 (6) ◽  
pp. F554-F561 ◽  
Author(s):  
Hidehiko Nakanishi ◽  
Hideyo Suenaga ◽  
Atsushi Uchiyama ◽  
Satoshi Kusuda
Keyword(s):  
Pulmonary Hypertension ◽  
Cohort Study ◽  
Preterm Infants ◽  
Research Network ◽  
Persistent Pulmonary Hypertension ◽  
Neurodevelopmental Outcomes ◽  
Significant Independent Risk Factor ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
The Impact

ObjectiveTo investigate the characteristics of persistent pulmonary hypertension of the newborn (PPHN) in extremely preterm infants and its impact on neurodevelopmental outcomes at 3 years of age.DesignA retrospective multicentre cohort study.Settings202 tertiary perinatal centres registered in the Neonatal Research Network of Japan (NRNJ).PatientsInfants born at <28 weeks of gestational age (GA), between 2003 and 2012, were extracted from tertiary perinatal centres participating in NRNJ.Main outcome measuresDemographic characteristics, morbidity, interventions and mortality were compared for infants with and without PPHN. Multivariable logistic analysis was performed to evaluate the impact of PPHN on long-term neurodevelopmental outcomes (the prevalence rate of cerebral palsy, need for home oxygen therapy, and visual, hearing and cognitive impairment) at 3 years of age.ResultsThe prevalence of PPHN among the 12 954 extremely preterm infants enrolled was 8.1% (95% CI 7.7% to 8.6%), with the trend increasing annually, and a higher proportion as GA decreased: 18.5% (range, 15.2% to 22.4%) for infants born at 22 weeks compared with 4.4% (range, 3.8% to 5.2%) for those born at 27 weeks. Clinical chorioamnionitis and premature rupture of membranes were associated with PPHN. On multivariate analysis of the data from 5923 infants followed up for 3 years, PPHN was a significant independent risk factor for visual impairment (adjusted OR, 1.42, 95% CI 1.03 to 1.97).ConclusionsThe prevalence of PPHN in extremely preterm infants has been increasing over the past decade in Japan. Clinicians should be aware of visual impairments as a neurodevelopmental abnormality among infants with PPHN.

scholarly journals Bronchopulmonary Dysplasia: Can We Agree on a Definition?

2018 ◽  
Vol 35 (06) ◽  
pp. 537-540 ◽  
Author(s):  
Deepak Jain ◽  
Eduardo Bancalari
Keyword(s):  
Respiratory Failure ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Nasal Cannula ◽  
Clinical Practices ◽  
Unique Challenge ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

AbstractThe advances in obstetric and neonatal care over the last half century have resulted in changes in pathophysiology and clinical presentation of bronchopulmonary dysplasia (BPD). In contrast to the original description of BPD by Northway et al as a severe lung injury in relatively mature preterm infants, the most common form of BPD currently is characterized by chronic respiratory insufficiency in extremely preterm infants. This evolution in the presentation of BPD, along with changes in respiratory support strategies such as increased use of nasal cannula oxygen, has presented a unique challenge to find a definition that describes the severity of lung damage and predict the long-term respiratory outcomes with some accuracy.The limitations of current definitions of BPD include inconsistent correlation with long-term respiratory outcomes, inability to classify infants dying from severe respiratory failure prior to 36 weeks' postmenstrual age, and potential inappropriate categorization of infants on nasal cannula oxygen or with extrapulmonary causes of respiratory failure. In the long term, the aim for a new definition of BPD is to develop a classification based on the pathophysiology and objective lung function evaluation providing a more accurate assessment for individual patients. Until then, a consensus definition that encompasses current clinical practices, provides reasonable prediction of later respiratory outcomes, and is relatively simple to use should be achieved.

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