Black Race Is Associated with a Lower Risk of Bronchopulmonary Dysplasia - 05/01/19

Doi : 10.1016/j.jpeds.2018.11.025

Rita M. Ryan, MD ^1,^* , Rui Feng, PhD ², Catalina Bazacliu, MD ³, Thomas W. Ferkol, MD ⁴, Clement L. Ren, MD, MBA ⁵, Thomas J. Mariani, PhD ⁶, Brenda B. Poindexter, MD, MS ⁷, Fan Wang, PhD ⁸, Paul E. Moore, MD ⁹
for the
Prematurity and Respiratory Outcome Program (PROP) Investigators^*
A list of additional members of the PROP Investigators is available at www.jpeds.com (Appendix).
Claire Chougnet, PhD ¹⁰, James M. Greenberg, MD ¹⁰, William Hardie, MD ¹⁰, Alan H. Jobe, MD, PhD ¹⁰, Karen McDowell, MD ¹⁰, Aaron Hamvas, MD ^11,¹², Mark R. Holland, PhD ¹¹, James Kemp, MD ¹¹, Philip T. Levy, MD ¹¹, Christopher McPherson, PharmD ¹¹, Phillip Tarr, MD ¹¹, Gautam K. Singh, MD ¹¹, Barbara Warner, MD ¹¹, Philip L. Ballard, MD, PhD ¹³, Roberta A. Ballard, MD ¹³, David J. Durand, MD ^13,¹⁴, Eric C. Eichenwald, MD ^13,¹⁵, Amir M. Khan, MD ¹³, Leslie Lusk, MD ¹³, Jeffrey D. Merrill, MD ^13,¹⁶, Dennis W. Nielson, MD, PhD ¹³, Elizabeth E. Rogers, MD ¹³, Judy Aschner, MD ^17,¹⁸, Candice Fike, MD ^17,¹⁹, Scott Guthrie, MD ^17,²⁰, Tina Hartert, MD ¹⁷, Nathalie Maitre, MD ¹⁷, Marshall Summar, MD ^17,²¹, Carl T. D'Angio, MD ^22,²³, Vasanth Kumar, MD ^22,²³, Gloria Pryhuber, MD ^22,²³, Anne Marie Reynolds, MD, MPH ^22,²³, Kristin Scheible, MD ^22,²³, Timothy Stevens, MD, MPH ^22,^23,^24,²⁵, C. Michael Cotten, MD ²⁶, Kim Fisher, PhD ²⁶, Jack Sharp, MD ^26,²⁷, Judith A. Voynow, MD ^26,²⁸, Stephanie Davis, MD ²⁴, Scarlett A. Bellamy, ScD ^29,³⁰, Jonas Ellenberg, PhD ²⁹, Melissa Fernando, MPH ²⁹, Howard Panitch, MD ²⁹, Pamela A. Shaw, PhD ²⁹, Barbara Schmidt, MD, MSc ²⁹, Lynn M. Taussig, MD ^30,³¹, Carol J. Blaisdell, MD ³⁰
¹⁰ Cincinnati Children's Hospital Medical Center
¹¹ Washington University School of Medicine
¹² Northwestern University Feinberg School of Medicine
¹³ University of California-San Francisco
¹⁴ Children's Hospital and Research Center Oakland, Oakland, CA
¹⁵ University of Texas Health Science Center- Houston, Houston, TX
¹⁶ Alta Bates Summit Medical Center, Berkeley, CA
¹⁷ Vanderbilt University
¹⁸ Albert Einstein College of Medicine, Bronx, NY
¹⁹ University of Utah
²⁰ Jackson-Madison County General Hospital, Jackson, TN
²¹ Children's National Health System, Washington, DC
²² University of Rochester
²³ University at Buffalo
²⁴ Indiana University
²⁵ Medical University of South Carolina
²⁶ Duke University
²⁷ Texas Children's Hospital
²⁸ Virginia Commonwealth University
²⁹ University of Pennsylvania, DCC
³⁰ Drexel University
³¹ University of Denver

¹ Department of Pediatrics, Medical University of South Carolina, Charleston, SC
² Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
³ Department of Pediatrics, University of Florida, Gainesville, FL
⁴ Department of Pediatrics, Washington University, St. Louis, MO
⁵ Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University, Indianapolis, IN
⁶ Department of Pediatrics, University of Rochester, Rochester, NY
⁷ Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
⁸ Department of Molecular Cardiology, Lerner Research Institute, The Cleveland Clinic, Cleveland, OH
⁹ Department of Pediatrics, Vanderbilt University, Nashville, TN

^*Reprint requests: Rita M. Ryan, MD, Pediatrics, 165 Ashley Ave, MSC 917, Charleston, SC 29425.Pediatrics165 Ashley AveMSC 917CharlestonSC29425

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 05 January 2019

Abstract

Objective

To use a large current prospective cohort of infants <29 weeks to compare bronchopulmonary dysplasia (BPD) rates in black and white infants.

Study design

The Prematurity and Respiratory Outcome Program (PROP) enrolled 835 infants born in 2011-2013 at <29 weeks of gestation; 728 black or white infants survived to 36 weeks postmenstrual age (PMA). Logistic regression was used to compare BPD outcomes (defined as supplemental oxygen requirement at 36 weeks PMA) between the races, adjusted for gestational age (GA), antenatal steroid use, intubation at birth, and surfactant use at birth.

Results

Of 707 black or white infants with available BPD outcomes, BPD was lower in black infants (38% vs 45%), even though they were of significantly lower GA. At every GA, BPD was more common in white infants. The aOR for BPD was 0.60 (95% CI, 0.42-0.85; P = .004) for black infants compared with white infants after adjusting for GA. Despite the lower rate of BPD, black infants had a higher rate of first-year post-prematurity respiratory disease (black, 79%; white, 63%).

Conclusions

In this large cohort of recently born preterm infants at <29 weeks GA, compared with white infants, black infants had a lower risk of BPD but an increased risk of persistent respiratory morbidity.

Le texte complet de cet article est disponible en PDF.

Abbreviations : ANS, BPD, ELGAN, GA, NIH, PMA, PRD, PROP, RDS

Plan

Supported by National Institutes of Health Grants U01 HL101794 (University of Pennsylvania), U01 HL101456 (Vanderbilt University), U01 HL101798 (University of California San Francisco), U01 HL101813 (University of Rochester and University at Buffalo), U01 HL101465 (Washington University), U01 HL101800 (Cincinnati Children's Hospital Medical Center), and 5R01 HL105702 (Indiana University and Duke University). The authors declare no conflicts of interest.

Portions of this study were presented at the Pediatric Academic Societies annual meeting, San Francisco, California, May 6-9, 2017.