Cargando…
Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children
Objective: To evaluate, in very preterm infants, the hemoglobin (Hb) levels during the first 24 h and the neurodevelopment outcomes at 24 months of corrected age. Design, setting, and patients: We conducted a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955539/ https://www.ncbi.nlm.nih.gov/pubmed/36832338 http://dx.doi.org/10.3390/children10020209 |
_version_ | 1784894371454255104 |
---|---|
author | Gire, Catherine Fournier, Ninon Pirrello, Johanna Marret, Stéphane Patural, Hugues Flamant, Cyril Pierrat, Véronique Kaminski, Monique Ancel, Pierre-Yves Tosello, Barthélémy Berbis, Julie |
author_facet | Gire, Catherine Fournier, Ninon Pirrello, Johanna Marret, Stéphane Patural, Hugues Flamant, Cyril Pierrat, Véronique Kaminski, Monique Ancel, Pierre-Yves Tosello, Barthélémy Berbis, Julie |
author_sort | Gire, Catherine |
collection | PubMed |
description | Objective: To evaluate, in very preterm infants, the hemoglobin (Hb) levels during the first 24 h and the neurodevelopment outcomes at 24 months of corrected age. Design, setting, and patients: We conducted a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2. The eligible study participants were live-born singletons who were born before 32 weeks of gestational age, with early Hb levels who were admitted to the neonatal intensive care unit. Main outcome measures: The early Hb levels for an outcome survival at 24 months of corrected age without neurodevelopmental impairment were measured. The secondary outcomes were survival at discharge and without severe neonatal morbidity. Results: Of the 2158 singletons of <32 weeks with mean early Hb levels of 15.4 (±2.4) g/dL, 1490 of the infants (69%) had a follow-up at two years of age. An early Hb of 15.2 g/dL is the minimum receiving operating characteristic curve at the 24 months risk-free level, but the area under the curve at 0.54 (close to 50%) indicates that this rate was not informative. In logistic regression, no association was found between early Hb levels and outcomes at two years of age (aOR 0.966; 95% CI [0.775–1.204]; p = 0.758) but rather there was a correlation found with severe morbidity (aOR 1.322; 95% CI [1.003–1.743]; p = 0.048). A risk stratification tree showed that male newborns of >26 weeks with Hb of <15.5 g/dL (n = 703) were associated with a poor outcome at 24 months (OR 1.9; CI: [1.5–2.4] p < 0.01). Conclusions: Early low Hb levels are associated with major neonatal morbidities in VP singletons, but not with neurodevelopment outcomes at two years of age, except in male infants of >26 Weeks GA. |
format | Online Article Text |
id | pubmed-9955539 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99555392023-02-25 Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children Gire, Catherine Fournier, Ninon Pirrello, Johanna Marret, Stéphane Patural, Hugues Flamant, Cyril Pierrat, Véronique Kaminski, Monique Ancel, Pierre-Yves Tosello, Barthélémy Berbis, Julie Children (Basel) Article Objective: To evaluate, in very preterm infants, the hemoglobin (Hb) levels during the first 24 h and the neurodevelopment outcomes at 24 months of corrected age. Design, setting, and patients: We conducted a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2. The eligible study participants were live-born singletons who were born before 32 weeks of gestational age, with early Hb levels who were admitted to the neonatal intensive care unit. Main outcome measures: The early Hb levels for an outcome survival at 24 months of corrected age without neurodevelopmental impairment were measured. The secondary outcomes were survival at discharge and without severe neonatal morbidity. Results: Of the 2158 singletons of <32 weeks with mean early Hb levels of 15.4 (±2.4) g/dL, 1490 of the infants (69%) had a follow-up at two years of age. An early Hb of 15.2 g/dL is the minimum receiving operating characteristic curve at the 24 months risk-free level, but the area under the curve at 0.54 (close to 50%) indicates that this rate was not informative. In logistic regression, no association was found between early Hb levels and outcomes at two years of age (aOR 0.966; 95% CI [0.775–1.204]; p = 0.758) but rather there was a correlation found with severe morbidity (aOR 1.322; 95% CI [1.003–1.743]; p = 0.048). A risk stratification tree showed that male newborns of >26 weeks with Hb of <15.5 g/dL (n = 703) were associated with a poor outcome at 24 months (OR 1.9; CI: [1.5–2.4] p < 0.01). Conclusions: Early low Hb levels are associated with major neonatal morbidities in VP singletons, but not with neurodevelopment outcomes at two years of age, except in male infants of >26 Weeks GA. MDPI 2023-01-25 /pmc/articles/PMC9955539/ /pubmed/36832338 http://dx.doi.org/10.3390/children10020209 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gire, Catherine Fournier, Ninon Pirrello, Johanna Marret, Stéphane Patural, Hugues Flamant, Cyril Pierrat, Véronique Kaminski, Monique Ancel, Pierre-Yves Tosello, Barthélémy Berbis, Julie Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children |
title | Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children |
title_full | Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children |
title_fullStr | Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children |
title_full_unstemmed | Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children |
title_short | Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children |
title_sort | impact of early hemoglobin levels on neurodevelopment outcomes of two-year-olds in very preterm children |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955539/ https://www.ncbi.nlm.nih.gov/pubmed/36832338 http://dx.doi.org/10.3390/children10020209 |
work_keys_str_mv | AT girecatherine impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT fournierninon impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT pirrellojohanna impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT marretstephane impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT paturalhugues impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT flamantcyril impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT pierratveronique impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT kaminskimonique impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT ancelpierreyves impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT tosellobarthelemy impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren AT berbisjulie impactofearlyhemoglobinlevelsonneurodevelopmentoutcomesoftwoyearoldsinverypretermchildren |