Neonatal pneumothorax – incidence and risk factors


Authors: Z. Uhríková 1;  D. Murgaš 2;  K. Maťašová 1;  M. Zibolen 1
Authors‘ workplace: Neonatologická klinika, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin 1;  Klinika detskej chirurgie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin 2
Published in: Čes-slov Pediat 2018; 73 (1): 23-30.
Category:

Overview

Objective:
Neonatal pneumothorax occurs as a common complication of underlying pulmonary disease or/and ventilatory support. Pneumothorax can also develop at the onset of respiration. The aim of the study was to establish rate, risk factors and outcome of neonates with pneumothorax hospitalized in Neonatal Intensive Care Unit of University Hospital Martin.

Methods:
Retrospective analysis was used to evaluate newborns admitted to Neonatal Intensive Care Unit University Hospital Martin from January 2010 to March 2017. Model of logistic regression was used for prediction of pneumothorax according to common risk factors in neonates divided according to gestation age in tree groups. Using logistic regression, we analyzed the relationship between the onset of pneumothorax and increased mortality, the incidence of bronchopulmonary dysplasia and intraventricular bleeding.

Results:
The study included 1962 newborns of which 421 (21.4%) were born <32 weeks GA, 824 (41.9%) were born in 32–36 weeks GA. and 717 (36.5%) were born in ≥37 weeks GA. The overall incidence of pneumothorax over follow up period was 3.0%, with the highest incidence of pneumothorax in the group of extremely and immature neonates 4.7%. Statistically significant risk factors were in the neonate group <32 week GA use of surfactant and artificial pulmonary ventilation as a form of initial ventilatory support, in 32–36 week GA diagnosed pulmonary pathology, early infection, surfactant administration and artificial lung ventilation, for newborns born ≥37 weeks GA use CPAP. In all three groups, the risk factor was birth outside the perinatal center. In early preterm neonates the pneumothorax was associated with increased mortality without affecting the incidence of bronchopulmonary dysplasia and intraventricular bleeding.

Conclusion:
The highest incidence of pneumothorax was observed in early preterm neonates. The identified statistically significant risk factors were almost similar for each gestational week. The identified risk factors were almost identical for each age group.

Key words:
newborn, pneumothorax, risk factors


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Neonatology Paediatrics General practitioner for children and adolescents
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