Neonatal factors related to center variation in the incidence of late-onset circulatory collapse in extremely preterm infants

Although late-onset circulatory collapse (LCC) is widely recognized in Japan, its etiology and the reason for center variation in its incidence remain unclear. This study's objectives were to identify the perinatal and neonatal factors related to LCC and to estimate the factors related to the c...

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Bibliographic Details
Published in:PloS one 2018-06, Vol.13 (6), p.e0198518-e0198518
Main Authors: Suzuki, Yume, Kono, Yumi, Hayakawa, Takahiro, Shimozawa, Hironori, Matano, Miyuki, Yada, Yukari
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Birth weight
Blood transfusion
Case-Control Studies
Collapse
Enterocolitis
Erythrocyte Transfusion
Erythrocytes
Etiology
Female
Gastrointestinal diseases
Gestational Age
Health aspects
High-Frequency Ventilation
Humans
Hypertension
Incidence
Infant, Extremely Premature
Infant, Newborn
Infant, Premature, Diseases - diagnosis
Infant, Premature, Diseases - epidemiology
Infants
Japan - epidemiology
Lung diseases
Male
Mechanical ventilation
Medicine and Health Sciences
Morbidity
Necrosis
Necrotizing enterocolitis
Neonates
Newborn babies
Nutrition
Odds Ratio
Parenteral nutrition
Pediatrics
People and Places
Periventricular leukomalacia
Physical Sciences
Pregnancy
Premature babies
Premature infants
Psychological aspects
Respiratory distress syndrome
Respiratory Distress Syndrome, Newborn - diagnosis
Respiratory Distress Syndrome, Newborn - epidemiology
Retinopathy
Retrospective Studies
Risk factors
Sex Factors
Shock
Steroid hormones
Steroids
Steroids - administration & dosage
Transfusion
Variation
Ventilation
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Summary:Although late-onset circulatory collapse (LCC) is widely recognized in Japan, its etiology and the reason for center variation in its incidence remain unclear. This study's objectives were to identify the perinatal and neonatal factors related to LCC and to estimate the factors related to the center variation in the incidence of LCC. Extremely preterm infants born between 2008 and 2012 who were registered in the database of the Neonatal Research Network, Japan were retrospectively analyzed. LCC was defined as a clinical diagnosis of LCC and the administration of steroids. We first identified the factors that were significantly related to LCC. We then examined the cause of the center variation in the incidence of LCC, using the standardized incidence ratios (SIRs) of LCC and individual factors. The factors significantly associated with LCC included low gestational age (odds ratio [OR]: 1.13), small for date (OR: 1.43), male sex (OR: 1.26), antenatal steroid use (OR: 1.19), respiratory distress syndrome (OR: 1.25), chronic lung disease at 36 weeks (OR: 1.16), periventricular leukomalacia (PVL) (OR: 2.57), necrotizing enterocolitis (OR: 0.59), retinopathy of prematurity (ROP) (OR: 1.73), high-frequency oscillating ventilation (HFOV) use (OR: 1.31), parenteral nutrition (OR: 1.38), and red blood cell (RBC) transfusion (OR: 1.94). The SIR of LCC ranged from 0.05 to 2.94, and was positively correlated with SIRs of PVL, ROP, HFOV use and RBC transfusion. PVL, ROP, HFOV use and RBC transfusion were found to be correlated with the center variation in the incidence of LCC.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0198518