351 - Intermittent Hypoxemia and Neurodevelopmental Impairment at 12 and 24 months in Preterm Infants

Publication Number: 351.5272

Juliann Di Fiore, Case Western Reserve University, Cleveland, OH, United States; Deanne Wilson-Costello, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Zhengyi Chen, Case Western Reserve University, Cleveland, OH, United States; Nori M. Minich, Case Western Reserve University School of Medicine, Cleveleand, OH, United States; Richard Martin, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Anna Maria Hibbs, UH Rainbow Babies & Children's Hospital, Cleveland, OH, United States

Background: Preterm birth is a risk factor for both short- and long-term sequelae. Children born prematurely are at increased risk for neurodevelopmental impairment (NDI) which may be identified as early as the first year of age, persist to early school age and extend into adulthood. Immature respiratory control and underdeveloped lungs associated with preterm birth contribute to intermittent hypoxemia (IH) during early postnatal life. Multiple infant studies have shown a relationship between increased IH events and long-term sequelae.

Objective: To assess the relationship between patterns of IH during the first month of life and neurodevelopmental impairment at 12 and 24 months of age.

Design/Methods: IH ( < 80% or < 90% for >10 sec and < 5min) were documented from day of life 8 to 28 in 175 infants born < 31 weeks gestation. Participants were screened for neurodevelopmental impairment with the Ages and Stages questionnaire (ASQ-3) at 12- and 24-months corrected age.

Results: Unadjusted models revealed a significant association between IH and gross motor, and communication skills at 12 months and gross motor, communication, fine motor, problem solving, and personal-social skills at 24 months. In adjusted models, only an association between longer % time with hypoxemia < 90% and communication skills (p=0.0158) at 12 months remained significant.

Conclusion(s): This study found a relationship between a wide range of IH parameters and ASQ-3 neurodevelopmental screening outcomes at 12 and 24 months. However, most did not remain significant after adjusting for confounders, apart from % time < 90% and communication skills at 12 months adjusted age. These data indicate that IH serves as a marker of immaturity or is part of the causal pathway between immaturity and neurodevelopmental impairment. Further 5-6 year assessments are ongoing as part of the Post-Vent multi-center trial.
Supported by NIH grants: U01HL133643, K24HL143291, U01HL133708, UM1TR004528