Relationship Between Early Respiratory Support and Neurodevelopment in Extremely Low Birth Weight Infants

Abstract

Objective: This study investigated relationship between early respiratory support and neurodevelopmental outcomes in extremely low birth weight infants. Methods: Our study included infants born before 32 weeks’ gestation at a birth weight of 750-1000 g that were admitted to the neonatal intensive care unit and underwent a neurodevelopmental evaluation at the corrected age of 24 months. Two hundred-twelve infants were divided into 3 groups by determining the predominant type of respiratory support required in the first 3 days of life. Infants who received supplemental oxygen therapy group 1, those who received nasal continuous positive airway pressure and/or nasal intermittent mandatory ventilation were in group 2, and intubated infants were included in group 3. Differences between the groups and relationships between neurodevelopment scores [mental development index (MDI); psychomotor development index (PDI)] were examined. Results: The patients mean birth weight was 887±73 g and mean gestational age was 27±1.9 weeks. MDI and PDI values were below 70 in the intubated patient group (68 and 66, respectively). Patients who received noninvasive ventilation or supplemental oxygen therapy for the first 3 days of life had significantly higher MDI and PDI values. In terms of morbidities of prematurity, intubated infants had higher rates of bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage, and retinopathy of prematurity. Conclusion: Restrictive invasive ventilation policies can be applied to preterm infants and may improve neurodevelopmental outcomes. The results of this study suggest that every additional day of invasive mechanical ventilation should be avoided if possible.