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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...

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Autores principales: Gire, Catherine, Fournier, Ninon, Pirrello, Johanna, Marret, Stéphane, Patural, Hugues, Flamant, Cyril, Pierrat, Véronique, Kaminski, Monique, Ancel, Pierre-Yves, Tosello, Barthélémy, Berbis, Julie
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
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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.
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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
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