Browsing by Author "Logan, J. Wells"

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    Association of Time of First Corticosteroid Treatment with Bronchopulmonary Dysplasia in Preterm Infants
    (Wiley, 2021) Cuna, Alain; Lagatta, Joanne M.; Savani, Rashmin C.; Vyas-Read, Shilpa; Engle, William A.; Rose, Rebecca S.; DiGeronimo, Robert; Logan, J. Wells; Mikhael, Michel; Natarajan, Girija; Truog, William E.; Kielt, Matthew; Murthy, Karna; Zaniletti, Isabella; Lewis, Tamorah R.; Children’s Hospitals Neonatal Consortium (CHNC) Severe BPD Focus Group; Pediatrics, School of Medicine
    Objective: To evaluate the association between the time of first systemic corticosteroid initiation and bronchopulmonary dysplasia (BPD) in preterm infants. Study design: A multi-center retrospective cohort study from January 2010 to December 2016 using the Children's Hospitals Neonatal Database and Pediatric Health Information System database was conducted. The study population included preterm infants <32 weeks' gestation treated with systemic corticosteroids after 7 days of age and before 34 weeks' postmenstrual age. Stepwise multivariable logistic regression was used to assess the association between timing of corticosteroid initiation and the development of Grade 2 or 3 BPD as defined by the 2019 Neonatal Research Network criteria. Results: We identified 598 corticosteroid-treated infants (median gestational age 25 weeks, median birth weight 760 g). Of these, 47% (280 of 598) were first treated at 8-21 days, 25% (148 of 598) were first treated at 22-35 days, 14% (86 of 598) were first treated at 36-49 days, and 14% (84 of 598) were first treated at >50 days. Infants first treated at 36-49 days (aOR 2.0, 95% CI 1.1-3.7) and >50 days (aOR 1.9, 95% CI 1.04-3.3) had higher independent odds of developing Grade 2 or 3 BPD when compared to infants treated at 8-21 days after adjusting for birth characteristics, admission characteristics, center, and co-morbidities. Conclusions: Among preterm infants treated with systemic corticosteroids in routine clinical practice, later initiation of treatment was associated with a higher likelihood to develop Grade 2 or 3 BPD when compared to earlier treatment.
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    Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia
    (Springer Nature, 2019-09-30) Vyas-Read, Shilpa; Wymore, Erica M.; Zaniletti, Isabella; Murthy, Karna; Padula, Michael A.; Truog, William E.; Engle, William A.; Savani, Rashmin C.; Yallapragada, Sushmita; Logan, J. Wells; Zhang, Huayan; Hysinger, Erik B.; Grover, Theresa R.; Natarajan, Girija; Nelin, Leif D.; Porta, Nicolas F. M.; Potoka, Karin P.; DiGeronimo, Robert; Lagatta, Joanne M.; Children’s Hospitals Neonatal Consortium Severe BPD Focus Group; Pediatrics, School of Medicine
    Objective: To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD). Study design: Infants with sBPD in the Children's Hospitals Neonatal Database who had echocardiograms 34-44 weeks' postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing. Results: Of 1157 infants, 115 infants (10%) died. Abnormal SP or RVSP increased mortality (SP 19% vs. 8% normal/missing, RVSP 20% vs. 9% normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95% CI 1.2-3.0; RVSP OR 2.2, 95% CI 1.1-4.7). Abnormal parameters had high specificity (SP 82%; RVSP 94%), and negative predictive value (SP 94%, NPV 91%) for mortality. Conclusions: Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.