Association between Pneumothorax and Neonatal Outcomes among Very Preterm Infants: A Multicenter Cohort Study
Bibliographic record
Abstract
INTRODUCTION: We aimed to evaluate whether the incidence of pneumothorax is associated with adverse neonatal outcomes in very preterm infants. METHODS: This multicenter cohort study included all infants with a gestational age of 24-31 weeks, admitted to the tertiary neonatal intensive care units of the Chinese Neonatal Network, from 2019 to 2022. Pneumothorax was diagnosed via chest X-ray or lung computed tomography. The primary outcome was a composite measure of mortality and/or any severe neonatal morbidity. Multivariable logistic or linear regression analyses were performed to assess the association between pneumothorax and neonatal outcomes. Propensity score matching was used to ensure the robustness of the results. RESULTS: Among the 37,917 infants in the study, 465 (1.2%) developed pneumothorax. Pneumothorax was significantly associated with a higher risk of mortality and/or severe neonatal morbidity (adjusted odds ratio = 3.15, 95% confidence interval: 2.36, 4.20). Pneumothorax exposure was also independently associated with increased mortality, severe intraventricular hemorrhage, moderate or severe bronchopulmonary dysplasia, and the need for invasive ventilation and its duration. Additionally, pneumothorax was associated with an increased length of hospital stay among survivors (adjusted odds ratio = 7.62, 95% confidence interval: 4.33, 10.91). The usage of high-frequency invasive mechanical ventilation before pneumothorax and pneumothorax treated with an intercostal chest drain seemed to have the most significant harmful effect (adjusted odds ratios were 3.34 and 3.27, respectively). CONCLUSION: Our study underscores the significant impact of pneumothorax on increasing mortality and severe morbidities in very preterm infants.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".