Scholarlink

Background <p>Premature newborns experience intermittent hypoxemia (IH) events during their birth hospitalization. The objective of the study was to determine if IH event frequency and duration are associated with improved prediction of Bronchopulmonary Dysplasia (BPD) severity in Extremely Low Gestational Age Newborns (ELGANs, &lt;29 weeks gestation).</p> Methods <p>Variables were extracted from an ELGAN data repository (<i>N</i> = 342) containing real-time data views from the electronic medical record and <i>N</i> = 115 with Q1-minute vital signs. IH was defined as a “SpO<sub>2</sub> low” event (&lt;85% O<sub>2</sub> saturation) lasting 10–300 seconds, with both frequency and duration recorded. BPD severity (primary outcome) was determined by the Neonatal Research Network (NRN) 2019 definition at 36 weeks’ postmenstrual age. Multinomial regression models were generated and compared with the 2022 NRN BPD Estimator, with and without IH data, at postnatal days (PND) 7, 14, and 28.</p> Results <p>IH duration, time spent below SpO<sub>2</sub> target range, and FiO<sub>2</sub> increased stepwise with BPD severity (<i>p</i> &lt; 0.0001), whereas IH frequency was similar. BPD severity prediction models that included IH duration were improved for Grade 2 BPD at PND 28 (AUROC 0.79).</p> Conclusions <p>Infants with worse BPD severity experience longer IH events. Some BPD severity predictions are enhanced when IH metrics are included.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Intermittent hypoxemia event frequency and duration have distinct trajectories over time. Adding intermittent hypoxemia to bronchopulmonary dysplasia models based on the Neonatal Research Network 2019 definition enhances the prediction of BPD severity at postnatal day 28, suggesting bedside monitoring data can help distinguish BPD endotypes earlier in disease progression.</p> </ItemContent> </UnorderedList></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Intermittent hypoxemia metrics enhance bronchopulmonary dysplasia severity predictions in extremely low gestational age newborns

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月30日

查看全文
  • Ananta Wadhwa,
  • Jack Chang,
  • Irina Prelipcean,
  • Colby Day,
  • Igor Khodak,
  • Nancy E. Roberston,
  • Charles Rosenberg,
  • Divya Chhabra,
  • Andrew M. Dylag

摘要

Background

Premature newborns experience intermittent hypoxemia (IH) events during their birth hospitalization. The objective of the study was to determine if IH event frequency and duration are associated with improved prediction of Bronchopulmonary Dysplasia (BPD) severity in Extremely Low Gestational Age Newborns (ELGANs, <29 weeks gestation).

Methods

Variables were extracted from an ELGAN data repository (N = 342) containing real-time data views from the electronic medical record and N = 115 with Q1-minute vital signs. IH was defined as a “SpO2 low” event (<85% O2 saturation) lasting 10–300 seconds, with both frequency and duration recorded. BPD severity (primary outcome) was determined by the Neonatal Research Network (NRN) 2019 definition at 36 weeks’ postmenstrual age. Multinomial regression models were generated and compared with the 2022 NRN BPD Estimator, with and without IH data, at postnatal days (PND) 7, 14, and 28.

Results

IH duration, time spent below SpO2 target range, and FiO2 increased stepwise with BPD severity (p < 0.0001), whereas IH frequency was similar. BPD severity prediction models that included IH duration were improved for Grade 2 BPD at PND 28 (AUROC 0.79).

Conclusions

Infants with worse BPD severity experience longer IH events. Some BPD severity predictions are enhanced when IH metrics are included.

Impact

Intermittent hypoxemia event frequency and duration have distinct trajectories over time. Adding intermittent hypoxemia to bronchopulmonary dysplasia models based on the Neonatal Research Network 2019 definition enhances the prediction of BPD severity at postnatal day 28, suggesting bedside monitoring data can help distinguish BPD endotypes earlier in disease progression.