72: Neurodevelopmental Outcomes of Neonates <29 Weeks GA Treated with Inhaled Steroids for Bronchopulmonary Dysplasia
Bibliographic record
Abstract
Bronchopulmonary dysplasia (BPD) is a major neonatal morbidity associated with adverse neurodevelopmental outcome at 18–24 months of age. Use of postnatal systemic corticosteroids has been shown to facilitate extubation and reduce the severity of BPD; however its use is associated with an increased risk of neurodevelopmental impairment mainly cerebral palsy (CP). Inhaled steroids are used alternatively, but their effect on neurodevelopmental outcome is not well documented. To evaluate the neurodevelopmental outcomes at 18–24 months of neonates <29 weeks GA with BPD who are treated with inhaled steroids vs. systemic steroids vs. no steroid treatment. This is a retrospective cohort study using data from the Canadian Neonatal Network (CNN) and the Canadian Neonatal Follow-Up Network (CNFUN) from April 2009 to September 2011. Neurodevelopmental impairment was defined as any one of Bayley III score <85 (cognition, motor or language), CP, or visual or hearing impairment. Severe impairment is defined as any one of: Bayley III score <70 for any of the three components, CP with gross motor function classification system (GMFCS) ≥3, severe visual impairment <20/200, or hearing impairment requiring aids/cochlear implant. Data for the three groups were compared using χ2 test and Student's t test as appropriate. Of the 4119 neonates born during the study period, 1339 (32.5%) developed BPD. Of the 1339 infants, 817 did not receive steroids and follow-up data was missing for 56 infants. Of the remaining 466 neonates with follow-up data, 63 received inhaled steroids, 403 systemic steroids. Adjusted OR (95% CI) for neurodevelopmental outcomes after adjustment for GA, SGA, outborn, mode of delivery, and SNAP-II scores are presented below. Table 1 In neonates <29 weeks GA who develop BPD, treatment with steroids is associated with worse outcome than those not treated with steroids. In comparing steroid treatment groups, inhaled steroids neither confers any benefit nor causes any harm compared to systemic steroids.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".