Delivery room intubation and neurodevelopment among extremely preterm infants

Kei Tamai; Naomi Matsumoto; Takashi Yorifuji; Akihito Takeuchi; Makoto Nakamura; Kazue Nakamura; Misao Kageyama; Neonatal Research Network of Japan

doi:10.1038/s41390-023-02993-5

Delivery room intubation and neurodevelopment among extremely preterm infants

Pediatr Res. 2024 Jan 11. doi: 10.1038/s41390-023-02993-5. Online ahead of print.

Authors

Kei Tamai¹, Naomi Matsumoto², Takashi Yorifuji², Akihito Takeuchi³, Makoto Nakamura³, Kazue Nakamura^{3

2}, Misao Kageyama³; Neonatal Research Network of Japan

Affiliations

¹ Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan. gmd501041@s.okayama-u.ac.jp.
² Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
³ Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.

PMID: 38212388
DOI: 10.1038/s41390-023-02993-5

Abstract

Background: The impact of delivery room intubation (DRI) on neurodevelopment in extremely preterm infants remains unclear.

Methods: We retrospectively analyzed data for infants born at 24-27 gestational weeks between 2003 and 2018. The primary outcome was neurodevelopmental impairment (NDI), defined as cerebral palsy or hearing, visual, or cognitive impairment at age 3 years. Secondary outcomes were NDI components and death before and after discharge from the neonatal intensive care unit. We conducted robust Poisson regression analyses, adjusting for perinatal confounders.

Results: The full cohort included 4397 infants with NDI data, of whom 3703 were intubated in the delivery room and 694 were not intubated in the delivery room. The mean gestational age and birth weight were 26.0 ± 1.1 weeks and 778 ± 184 g for infants with DRI and 26.6 ± 1.0 weeks and 873 ± 184 g for infants without DRI. Compared with infants without DRI, those with DRI had a higher risk for NDI (32.4% vs. 23.3%; adjusted risk ratio 1.18, 95% confidence interval: 1.01-1.37). There were no differences in secondary outcomes between infants with and without DRI.

Conclusions: DRI was associated with an increased risk for NDI at age 3 years among extremely preterm infants.

Impact: Few studies have examined the impact of delivery room intubation on neurodevelopment in infants born extremely preterm, and the results have been inconsistent. A total of 4397 infants born at 24-27 gestational weeks who had neurodevelopmental data at age 3 years were included in the present study. The present study found that delivery room intubation was associated with an increased risk for neurodevelopmental impairment at age 3 years among extremely preterm infants.