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. 2016 Oct 11;6(10):e011643.
doi: 10.1136/bmjopen-2016-011643.

Respiratory distress syndrome in moderately late and late preterm infants and risk of cerebral palsy: a population-based cohort study

Sandra Kruchov Thygesen  1 , Morten Olsen  1 , John R Østergaard  2 , Henrik Toft Sørensen  3
Affiliations

Respiratory distress syndrome in moderately late and late preterm infants and risk of cerebral palsy: a population-based cohort study

Sandra Kruchov Thygesen et al. BMJ Open. .

Abstract

Objectives: Infant respiratory distress syndrome (IRDS) is a known risk factor for intracerebral haemorrhage/intraventricular haemorrhage (ICH/IVH) and periventricular leucomalacia. These lesions are known to increase the risk of cerebral palsy (CP). Thus, we wanted to examine the long-term risk of CP following IRDS in moderately late and late preterm infants.

Design: Population-based cohort study.

Setting: All hospitals in Denmark.

Participants: We used nationwide medical registries to identify a cohort of all moderately and late preterm infants (defined as birth during 32-36 full gestational weeks) born in Denmark in 1997-2007 with and without hospital diagnosed IRDS.

Main outcomes measures: We followed study participants from birth until first diagnosis of CP, emigration, death or end of follow-up in 2014. We computed the cumulative incidence of CP before age 8 years and used Cox's regression analysis to compute HRs of IRDS, comparing children with IRDS to those without IRDS. HRs were adjusted for multiple covariates.

Results: We identified 39 420 moderately late and late preterm infants, of whom 2255 (5.7%) had IRDS. The cumulative incidence of CP was 1.9% in infants with IRDS and 0.5% in the comparison cohort. The adjusted HR of CP was 2.0 (95% CI 1.4 to 2.9). The adjusted HR of CP was 12 (95% CI 4.5 to 34) in children with IRDS accompanied by a diagnosis of ICH/IVH. After restriction to children without diagnoses of perinatal breathing disorders other than IRDS, congenital heart disease and viral or bacterial infections occurring within 4 days of birth, the overall adjusted HR was 2.1 (95% CI 1.4 to 3.1).

Conclusions: The risk of CP was increased in moderately late and late preterm infants with IRDS compared with infants without IRDS born during the same gestational weeks.

Keywords: EPIDEMIOLOGY; PERINATOLOGY; cerebral palsy; cohort study; neurodevelopmental disorder; respiratory distress syndrome.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Cumulative incidence of cerebral palsy in 24 728 children with and without infant respiratory distress syndrome (IRDS) in Denmark during 1997–2003.
See this image and copyright information in PMC

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