The Impact of Altitude at Birth on Perinatal Respiratory Support for Neonates with Trisomy 21-Reference-Cited by-同舟云学术

The Impact of Altitude at Birth on Perinatal Respiratory Support for Neonates with Trisomy 21

Published:2021-10-21 Issue: Volume: Page:
ISSN:0735-1631
Container-title:American Journal of Perinatology
language:en
Short-container-title:Am J Perinatol

Author:

Bloom Jessica L.¹^ORCID,Furniss Anna²,Suresh Krithika³,Fuhlbrigge Robert C.¹,Lamb Molly M.⁴,Rosenberg Sophie⁵,Edwards Anastasia⁶,O'Leary Sean T.⁷

Affiliation:

1. Department of Pediatrics, Section of Pediatric Rheumatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado

2. Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado

3. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado

4. Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, Colorado

5. Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado

6. Colorado Department of Public Health and Environment, Denver, Colorado

7. Department of Pediatrics, Section of Infectious Disease; Investigator, Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado

Abstract

Objective Both high altitude and trisomy 21 (T21) status can negatively impact respiratory outcomes. The objective of this study was to examine the association between altitude and perinatal respiratory support in neonates with T21 compared with those without T21. Study Design This retrospective cohort study used the United States all-county natality files that included live, singleton, in-hospital births from 2015 to 2019. Descriptive statistics for neonates with and without the primary outcome of sustained assisted ventilation (>6 hours) were compared using t-tests and Chi-squared analyses. Multivariable logistic regression was used to determine the association between respiratory support and the presence of T21, and included an interaction term to determine whether the association between respiratory support and the presence of T21 was modified by elevation at delivery. Results A total of 17,939,006 neonates, 4,059 (0.02%) with T21 and 17,934,947 (99.98%) without, were included in the study. The odds of requiring sustained respiratory support following delivery were 5.95 (95% confidence interval [CI]: 5.31, 6.66), 4.06 (95% CI: 2.39, 6.89), 2.36 (95% CI: 1.64, 3.40), and 5.04 (95% CI: 1.54, 16.54) times as high for neonates with T21 than without T21 when born at low, medium, high, and very high elevations, respectively. The odds of requiring immediate ventilation support following delivery were 5.01 (95% CI: 4.59, 5.46), 5.90 (95% CI: 4.16, 8.36), 2.86 (95% CI: 2.15, 3.80), and 12.08 (95% CI: 6.78, 21.51) times as high for neonates with T21 than without T21 when born at low, medium, high, and very high elevation, respectively. Conclusion Neonates with T21 have increased odds of requiring respiratory support following delivery when compared with neonates without T21 at all categories of altitude. However, the odds ratios did not increase monotonically with altitude which indicates additional research is critical in understanding the effects of altitude on neonates with T21. Key Points

Funder

NIH/NCATS Colorado CTSI

NIH T32 Research Training in Rheumatology

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynaecology,Pediatrics, Perinatology, and Child Health

Link

http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1736594.pdf

Reference22 articles.

1. Clinical characteristics of pulmonary arterial hypertension associated with Down syndrome;T Saji;Pediatr Int,2014

2. Neonatal characteristics and perinatal complications in neonates with Down syndrome;Z Ergaz-Shaltiel;Am J Med Genet A,2017

3. Management and outcomes of neonates with Down syndrome admitted to neonatal units;J P Mann;Birth Defects Res A Clin Mol Teratol,2016

4. Infants born with Down syndrome: burden of disease in the early neonatal period;T Martin;J Pediatr,2018

5. NICU management and outcomes of infants with trisomy 21 without major anomalies;S McAndrew;J Perinatol,2018