Tracheal Intubation in Term Infants—Trends, Risk Factors, and Outcomes: A Population-Based Study [A281]. (May 2022)

• Record Type: Journal Article
• Authors: Debay, Anthony; Beltempo, Marc; Czuzoj-Shulman, Nicholas; Abenhaim, Haim A.
• Is Part Of: Obstetrics and gynecology. Volume 139(2022)Supplement 1
• Page Start: 81S
• Page End: 81S
• Publication Date: 2022-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000825684.39661.7d
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Tracheal intubation (TI) is associated with hypoxia and an increase in intracranial pressure, potentially leading to brain injury. We aimed to estimate trends, risk factors, and outcomes among term neonates undergoing TI, using a large population-based database. METHODS: This is a retrospective cohort study of 2, 122, 245 births using the Healthcare Cost and Utilization Project/Nationwide Inpatient Sample from 2015 to 2018. Term infants having undergone TI were identified using ICD-10 codes. Infants with congenital anomalies were excluded. Multivariate logistic regression models were used to evaluate outcomes while adjusting for confounders. RESULTS: Rate of death was 4.4% among the 13, 205 infants who had TI, and 0.04% among the 2, 109, 040 infants who did not have TI. Infants undergoing TI in urban teaching hospitals had higher odds of death compared to infants in rural hospitals (OR 1.77, 95% CI 1.17–2.69). Infants who had TI and died had higher odds of intraventricular hemorrhage (IVH; OR 5.28, 95% CI 4.08–6.83), hypoxic-ischemic encephalopathy (HIE; OR 2.34, 95% CI 1.86–2.94), and sepsis (OR 1.50, 95% CI 1.23–1.83); pulmonary hemorrhage (PH) was the greatest predictor of death (OR 7.34, 95% CI 5.17–10.42). Among infants who had TI and survived, odds of IVH (OR 76.24, 95% CI 67.33–86.32), HIE (OR 291.86, 95% CI 263.26–323.56), sepsis (OR 28.76, 95% CI 27.39–30.31), and PH (OR 542.01, 95% CI 384.73–763.58) were higher compared to controls. CONCLUSION: Term infants undergoing TI have higher mortality rates compared to controls; TI survivors have an increased risk of neurological sequelae. Non-invasive respiratory support and postnatal neuroprotective interventions should be optimized in term infants.