376 - Impact of early life respiratory support on long-term respiratory outcomes by 17 years of age among children born late preterm and term: a population-based study using health services data

Publication Number: 376.5429

Jacqui van Warmerdam, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; YE SHEN, BC Children's Hospital Research Institute, Richmond, BC, Canada; Lindsay Richter, University of British Columbia, Vancouver, BC, Canada; Jeffrey N.. Bone, BC Children's Hosiptal Research Institute, Vancouver, BC, Canada; Jonathan Wong, BC Children’s and Women’s Hospital, Vancouver, BC, Canada; sarka Lisonkova, UBC, Vancouver, BC, Canada; Ashley Roberts, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Connie Yang, British Columbia Children's Hospital, Vancouver, BC, Canada; Emily Kieran, Children's and Women's Health Centre of BC, Vancouver, BC, Canada; Joseph Ting, University of Alberta, Edmonton, AB, Canada

Background: While neonatal respiratory support has led to increased infant survival, the long-term respiratory disease burden among its late preterm and term infant recipients is unknown.

Objective: Our study used population-based data to describe risk of respiratory disease among infants who received neonatal respiratory support.

Design/Methods: A retrospective cohort of infants born in British Columbia between 2004-2014 was identified using a provincial birth registry. By linking to population-based healthcare data, we captured demographics, birth data, and respiratory-cause healthcare visits up to 17 years of age. The rate of hospitalization for asthma, pneumonia, and vaccine preventable infection was compared between infants who received early life invasive mechanical ventilation (IMV), and non-invasive respiratory support (NIV; including supplemental oxygen) using Poisson regression.

Results: Infants who received NIV (late preterm n=3415; term n=8309) were compared to infants who received IMV (late preterm n=779, term n=1505) in 5-10 year and 10-17 year follow up cohorts. Late preterm infants (34-36 weeks GA) experienced more asthma (NIV 16.3%, IMV 15.8%) compared to term infants (37-44 weeks GA; NIV 12.4%, IMV 13.6%) and more influenza (NIV 6.6%, IMV 7.1%) compared to term infants (NIV 6.2%, IMV 4.7%). The proportion affected by respiratory disease decreased with older child age. There was no significant difference in respiratory cause healthcare contacts among infants who received IMV compared to NIV in the first 5-10 years of life. However, in the overall 10-17 year cohort, infants who received IMV had increased rates of asthma [rate ratio (RR) 1.12, 95% CI 1.05-1.20], pneumonia (RR 1.14, 95% CI 1.06-1.22), respiratory hospitalization (RR 1.14, 95% CI 1.06-1.22), and influenza (RR 1.13, 95% CI 1.05-1.2) compared to infants who received NIV. Late preterm infants who received IMV had an increased rate of influenza (RR 1.13, 95%CI 1.003-1.27).

Conclusion(s): Among infants who received neonatal respiratory support, late preterm infants experienced more asthma and influenza than term infants. This burden of respiratory disease decreased with older child age. Infants who received IMV had no increased risk of long-term respiratory disease compared to those who received NIV in the 5-10 year follow up; however, in the 10-17 year follow up, infants who received IMV experienced significantly higher rates of all respiratory outcomes. Our study is the first to use population-based data to describe the rate of respiratory-cause healthcare contacts among infants who received respiratory support.

Table 1. Demographic characteristics of term and late preterm infants who received early life invasive ventilation or non-invasive respiratory support in British Columbia, 2004-2014.


Table 2. Major respiratory morbidities at 5-10 years of age among infants requiring neonatal respiratory support.


Table 3. Major respiratory morbidities at 10-17 years of age among infants requiring neonatal respiratory support.