Inpatient morbidities and medical technology use at 2 years among extremely preterm infants.
Date
2025-12
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Abstract
Background
Extremely preterm infants may use medical technology after discharge from neonatal intensive care. The aim of the study was to determine which inpatient morbidities have the strongest associations with technology at toddler-age follow-up.Methods
Retrospective cohort analysis of 3904 extremely preterm infants born 22.0-26.6 weeks' gestation from 2014 to 2019 who survived to 36 weeks' postmenstrual age and had data on medical technology at 22-26 months' corrected gestational age.Results
18.8% of children used medical technology; 10.1% used one and 8.7% ≥ 2. Use of a gastrostomy tube was most common (12.8%), followed by pulse oximeter (8.2%), oxygen (5.9%), tracheostomy (3.9%), shunt for hydrocephalus (3.6%), ventilator/continuous positive airway pressure (2.2%), apnea monitor (1.4%), and total parenteral nutrition (0.3%). After adjusting for significant maternal and infant characteristics, Grade 2 or 3 bronchopulmonary dysplasia (BPD) was most strongly associated with medical technology (aOR (95% CI): 3.20 (2.65, 3.87)), followed by serious brain injury (SBI) 3.06 (2.55, 3.66) and surgical NEC (sNEC) 2.67 (1.84, 3.87).Conclusions and relevance
In this cohort of extremely preterm infants, BPD, SBI and sNEC were most associated with medical technology use at toddler-age. These findings provide information for counseling of families and support during discharge planning.Clinicaltrials
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Generic Database: NCT00063063.Impact
In this cohort of extremely preterm infants <27 weeks' gestation at birth, nearly 1 in 5 children used medical technology at 22-26 months' corrected age. The inpatient morbidities of bronchopulmonary dysplasia, serious brain injury, and surgical necrotizing enterocolitis were most associated with persistent medical technology use. These findings provide important information for counseling families of children with these morbidities during the hospital stay and call for increased support of these families after discharge.Type
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Publication Info
Dorner, Rebecca A, Lei Li, Monica E Lemmon, Sahar Z Zangeneh, Abhik Das, Deborah A Discenza, Toni Mancini, Yvonne Vaucher, et al. (2025). Inpatient morbidities and medical technology use at 2 years among extremely preterm infants. Pediatric research. 10.1038/s41390-025-04671-0 Retrieved from https://hdl.handle.net/10161/34782.
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Scholars@Duke
Monica Elizabeth Lemmon
Kathryn E. Gustafson
My scholarly interests and expertise are in pediatric neurodevelopmental outcomes assessment and research as well as child and parent coping with chronic childhood illness. In the 1990s, I collaborated with Dr. Robert Thompson in investigating the transactional biopsychosocial model of adaptation to pediatric conditions in children and families. Our research program was funded by the NIH and culminated in the publication of our book, Adaptation to Chronic Childhood Illness. Since that time, I have worked closely with the Division of Neonatology and the Duke Neonatal-Perinatal Research Unit on neurodevelopmental outcomes research with high-risk infants, toddlers, and school-age children. I am a gold standard psychology consultant to the Neonatal Research Network (NRN) of the NIH/NICHD, train and certify psychologists nationally and internationally in infant and toddler developmental assessment for numerous research groups, and serve as consultant for protocol development. In addition, I collaborate with colleagues in Pediatric Ophthalmology to investigate preterm optic nerve anatomy assessed via optical coherence tomography imaging and the association with neurodevelopment. I am also involved in investigations of umbilical cord blood stem cell transplant for young children with hypoxic ischemic encephalopathy, cerebral palsy, and inborn errors of metabolism, such as Krabbe disease, with colleagues in the Pediatric Transplant and Cellular Therapy program.
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