Evidence map›Paper›PMID 38231237›Full record

ArticleEuropean journal of pediatrics2024

Synergistic effects of achieving perinatal interventions on bronchopulmonary dysplasia in preterm infants.

Xiang Chen, Lin Yuan, Siyuan Jiang, Xinyue Gu, Xiaoping Lei, Liyuan Hu, Tiantian Xiao, Yanping Zhu, Dan Dang, Wenli Li and 7 more

Abstract read
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In one paragraph

Article in European journal of pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Xiang Chen *Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Lin Yuan *Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Siyuan JiangDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Xinyue GuNHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China.
Xiaoping LeiDivision of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Liyuan HuDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Tiantian XiaoDepartment of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Yanping ZhuDepartment of Neonatology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Dan DangDepartment of Neonatology, The First Hospital of Jilin University, Changchun, China.
Wenli LiDepartment of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yun CaoDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Lizhong DuNeonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shoo K LeeMaternal-Infant Care Research Centre and Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada.
Chao ChenDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Wenhao ZhouDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China. zhouwenhao@fudan.edu.cn.
Jianguo ZhouDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, China. joezhou@fudan.edu.cn.
Chinese Neonatal Network

Funding

CIHR CTP87518
6 · The paper itself

Abstract

To investigate the effect of perinatal interventions on the risk of severe BPD (sBPD) and death in extremely preterm infants (EPIs) and their synergistic effects. This was a secondary analysis of the prospective cohort Chinese Neonatal Network (CHNN). Infants with a birth weight of 500 to 1250 g or 24-28 weeks completed gestational age were recruited. The impacts and the synergistic effects of six evidence-based perinatal interventions on the primary outcomes of sBPD and death were assessed by univariate and multivariable logistic regression modeling. Totally, 6568 EPIs were finally enrolled. Antenatal corticosteroid (adjusted OR, aOR, 0.74; 95%CI, 0.65-083), birth in centers with tertiary NICU (aOR, 0.64; 95%CI, 0.57-0.72), preventing intubation in the delivery room (aOR, 0.65; 95%CI, 0.58-0.73), early caffeine therapy (aOR, 0.59; 95%CI, 0.52-0.66), and early extubating (aOR, 0.42; 95%CI 0.37-0.47), were strongly associated with a lower risk of sBPD and death while early surfactant administration was associated with a lower risk of death (aOR, 0.84; 95%CI, 0.72, 0.98). Compared with achieving 0/1 perinatal interventions, achieving more than one intervention was associated with decreased rates (46.6% in 0/1 groups while 38.5%, 29.6%, 22.2%, 16.2%, and 11.7% in 2/3/4/5/6-intervention groups respectively) and reduced risks of sBPD/death with aORs of 0.76(0.60, 0.96), 0.55(0.43, 0.69), 0.38(0.30, 0.48), 0.28(0.22, 0.36), and 0.20(0.15, 0.27) in 2, 3, 4, 5, and 6 intervention groups respectively. Subgroup analyses showed consistent results.

conclusionSix perinatal interventions can effectively reduce the risk of sBPD and death in a synergistic form. WHAT IS KNOWN: • Bronchopulmonary dysplasia (BPD) is a multifactorial chronic lung disease associated with prematurity. The effective management of BPD requires a comprehensive set of interventions. However, the extent to which these interventions can mitigate the risk of severe outcomes, such as severe BPD or mortality, or if they possess synergistic effects remains unknown. WHAT IS NEW: • The implementation of various perinatal interventions, such as prenatal steroids, birth in centers with tertiary NICU, early non-Invasive respiratory support, surfactant administration within 2 hours after birth, early caffeine initiation within 3 days, and early extubation within 7 days after birth has shown promising results in the prevention of severe bronchopulmonary dysplasia (BPD) or mortality in extremely preterm infants. Moreover, these interventions have demonstrated synergistic effects when implemented in combination.

Indexed as

Bronchopulmonary DysplasiaPulmonary SurfactantsCaffeineFemaleGestational AgeHumansInfantInfant, Extremely PrematureInfant, NewbornPregnancyProspective StudiesSurface-Active AgentsCaffeinePulmonary SurfactantsSurface-Active AgentsBronchopulmonary dysplasiaExtremely preterm infantsPerinatal interventionsSynergistic effects

Identifiers

PMID38231237

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.