Respiratory Distress Management in Moderate and Late Preterm Infants: The NEOBS Study

T. Debillon (1) , Pierre Tourneux (2, 3) , I. Guellec (4) , P.-H. Jarreau (5) , Cyril Flamant (6)

1 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
2 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
3 Soins Intensifs de Néonatologie et Médecine Néonatale / Réanimation et Surveillance Continue de Pédiatrie [CHU Amiens]
4 CHU Trousseau [APHP]
5 Maternité Port-Royal [CHU Cochin]
6 CHU Nantes - Centre Hospitalier Universitaire de Nantes

Objective: To investigate the characteristics and management of respiratory failure (RF) in moderate-to-late preterm infants. Methods: NEOBS was a prospective, multicenter, observational study conducted in 46 neonatal intensive care units caring for preterm infants (30 + 0/7 to 36 + 6/7 weeks of gestation [WG]) in France in 2018. The cohort was stratified into two groups: 30\textendash 33 WG (group 1) and 34\textendash 36 WG (group 2). Infants with early neonatal RF were included and the outcomes assessed were maternal, pregnancy, and delivery characteristics and how RF was managed. Results: Of the 560 infants analyzed, 279 were in group 1 and 281 were in group 2. Most pregnancies were singleton (64.1%), and 67.4% of women received prenatal corticosteroids (mostly two doses). Infants were delivered by cesarean section in 59.6% of cases; 91.7% of the infants had an Apgar score ≥q 7 at 5 min. More than 90% of infants were hospitalized post-birth (median duration, 36 and 15 days for groups 1 and 2, respectively). Medical intervention was required for 95.7% and 90.4% of the infants in group 1 and group 2, respectively, and included noninvasive ventilation (continuous positive airway pressure [CPAP]: 88.5% and 82.9%; high-flow nasal cannula: 55.0% and 44.7%, or other) and invasive ventilation (19.7% and 13.2%). The two main diagnoses of RF were respiratory distress syndrome (39.8%) and transient tachypnea of the newborn (57.3%). Surfactant was administered to 22.5% of the infants, using the less invasive surfactant administration (LISA) method for 34.4% of the patients. In the overall population, 8.6% of the infants had respiratory and/or hemodynamic complications. Conclusions: The NEOBS study demonstrated that CPAP was widely used in the delivery room and the LISA method was chosen for 34.4% of the surfactant administrations for the management of RF in moderate-to-late preterm infants. The incidence of RF-related complications was low. \textcopyright 2021 French Society of Pediatrics

Mots clés: Moderate/late preterm; Outcomes; Respiratory distress syndrome

Domaines: Sciences du Vivant [q-bio]

T. Debillon, Pierre Tourneux, I. Guellec, P.-H. Jarreau, Cyril Flamant. Respiratory Distress Management in Moderate and Late Preterm Infants: The NEOBS Study. Archives de Pédiatrie, 2021, 28 (5), pp.392-397. ⟨10.1016/j.arcped.2021.03.010⟩. ⟨hal-03688181⟩