Early extubation is not associated with severe intraventricular hemorrhage in preterm infants born before 29 weeks of gestation. Results of an EPIPAGE-2 cohort study

To determine whether there is an association between severe intraventricular hemorrhage and early extubation in preterm infants born before 29 weeks of gestational age and intubated at birth. This study included 1587 preterm infants from a nationwide French population cohort (EPIPAGE-2). Secondary d...

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Veröffentlicht in:PloS one 2019-04, Vol.14 (4), p.e0214232-e0214232
Hauptverfasser: Chevallier, Marie, Ancel, Pierre-Yves, Torchin, Héloïse, Marchand-Martin, Laetitia, Lorthe, Elsa, Truffert, Patrick, Jarreau, Pierre Henri, Roze, Jean Christophe, Pierrat, Véronique, Marret, Stéphane, Baud, Olivier, Benhammou, Valérie, Ego, Anne, Debillon, Thierry
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creator Chevallier, Marie
Ancel, Pierre-Yves
Torchin, Héloïse
Marchand-Martin, Laetitia
Lorthe, Elsa
Truffert, Patrick
Jarreau, Pierre Henri
Roze, Jean Christophe
Pierrat, Véronique
Marret, Stéphane
Baud, Olivier
Benhammou, Valérie
Ego, Anne
Debillon, Thierry
description To determine whether there is an association between severe intraventricular hemorrhage and early extubation in preterm infants born before 29 weeks of gestational age and intubated at birth. This study included 1587 preterm infants from a nationwide French population cohort (EPIPAGE-2). Secondary data on intubated preterm infants were analyzed. After gestational age and propensity score matching (1:1) we built two comparable groups: an early extubation group and a delayed extubation group. Each neonate in one group was paired with a neonate in the other group having the same propensity score and gestational age. Early extubation was defined as extubation within 48 hours of life. Severe intraventricular hemorrhages were defined as grade III or IV hemorrhages according to the Papile classification. After matching, there were 398 neonates in each group. Using a generalized estimating equation model, we found that intraventricular hemorrhage was not associated with early extubation (adjusted OR 0.9, 95%CI 0.6-1.4). This result was supported by sensitivity analyses. The practice of early extubation was not associated with an increased proportion of intraventricular hemorrhages. To complete these results, the long-term neurologic outcomes of these infants need to be assessed.
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Results of an EPIPAGE-2 cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-04-04</date><risdate>2019</risdate><volume>14</volume><issue>4</issue><spage>e0214232</spage><epage>e0214232</epage><pages>e0214232-e0214232</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To determine whether there is an association between severe intraventricular hemorrhage and early extubation in preterm infants born before 29 weeks of gestational age and intubated at birth. This study included 1587 preterm infants from a nationwide French population cohort (EPIPAGE-2). Secondary data on intubated preterm infants were analyzed. After gestational age and propensity score matching (1:1) we built two comparable groups: an early extubation group and a delayed extubation group. Each neonate in one group was paired with a neonate in the other group having the same propensity score and gestational age. Early extubation was defined as extubation within 48 hours of life. Severe intraventricular hemorrhages were defined as grade III or IV hemorrhages according to the Papile classification. After matching, there were 398 neonates in each group. Using a generalized estimating equation model, we found that intraventricular hemorrhage was not associated with early extubation (adjusted OR 0.9, 95%CI 0.6-1.4). This result was supported by sensitivity analyses. The practice of early extubation was not associated with an increased proportion of intraventricular hemorrhages. To complete these results, the long-term neurologic outcomes of these infants need to be assessed.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30946750</pmid><doi>10.1371/journal.pone.0214232</doi><tpages>e0214232</tpages><orcidid>https://orcid.org/0000-0002-1589-0144</orcidid><orcidid>https://orcid.org/0000-0002-9654-8104</orcidid><orcidid>https://orcid.org/0000-0001-5021-0522</orcidid><orcidid>https://orcid.org/0000-0001-6568-0324</orcidid><orcidid>https://orcid.org/0000-0002-1025-910X</orcidid><orcidid>https://orcid.org/0000-0003-4699-5384</orcidid><orcidid>https://orcid.org/0000-0002-2858-148X</orcidid><orcidid>https://orcid.org/0000-0001-9947-270X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Age
Airway Extubation - adverse effects
Biology and Life Sciences
Cerebral Hemorrhage - etiology
Cohort analysis
Cohort Studies
Epidemiology
Extubation
Female
Gestation
Gestational age
Health aspects
Hemorrhage
Humans
Infant, Premature - physiology
Infants
Intensive care
Intraventricular hemorrhage
Intubation
Life Sciences
Matching
Medicine and Health Sciences
Methods
Neonates
Newborn babies
Newborn infants
Pediatrics
Physical Sciences
Population
Pregnancy
Premature babies
Premature Birth - pathology
Premature infants
Propensity Score
Research and Analysis Methods
Respiratory therapy
Risk Factors
Sensitivity analysis
Surfactants
Ventilators
title Early extubation is not associated with severe intraventricular hemorrhage in preterm infants born before 29 weeks of gestation. Results of an EPIPAGE-2 cohort study
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