Prolonged Hyperoxia Exposure is an Independent Predictor for Moderate to Severe Neurodevelopmental Impairment in Extremely Premature Neonates

Retrospective cohort study of extremely preterm infants (< 28 weeks’ gestational age and birth weight ≤ 1500 g) treated at a level IV academic hospital from January 2008 to July 2018 to assess if prolonged hyperoxia is an independent risk factor for severe neurodevelopmental impairment (NDI) or death.Among 546 former extremely preterm infants, 327 (59.9%) were exposed to prolonged hyperoxia. Prolonged hyperoxia was associated with increased odds of severe NDI or death (OR 1.77, 95% CI 1.01 to 3.14) after adjusting for risk factors. When the components of the primary outcome were analyzed separately, prolonged hyperoxia was not associated with severe NDI among survivors (OR 1.39, 95% CI 0.74 to 2.63) but was associated with death (OR 3.20, 95% CI 1.23 to 9.59). In conclusion, prolonged exposure to oxygen is a significant and independent risk factor for development of long-term moderate to severe NDI including death.