Early inspired oxygen and intermittent hypoxemic events in extremely premature infants are associated with asthma medication use at two years of age

OBJECTIVE: Extremely premature infants are at risk for childhood wheezing. Early respiratory support and intermittent hypoxemia (IH) events may be associated with adverse breathing outcomes. STUDY DESIGN: A single-center retrospective cohort study of 137 premature infants <28 weeks gestational age characterized the associations of cumulative oxygen, cumulative mean airway pressure, IH, and oxygen saturation (SpO(2)) on the primary outcome of prescription asthma medication use at 2 year follow-up. Relative risk was calculated by generalized estimating equations. RESULTS: Reported asthma medication use was 46%. At 1–3 days of age, elevated cumulative oxygen exposure, increased daily IH, and lower mean SpO(2) (adjusted for gestational age and sex) and increased cumulative mean airway pressure exposure (unadjusted) were associated with asthma medication use. CONCLUSION: Increased oxygen and frequent IH events during just the first three days of age may help identify extremely premature newborns at risk for symptomatic childhood wheezing requiring prescription asthma medications.