Table 2.
Predictors for an unsuccessful INSURE procedure in 291 neonates born before 32 weeks gestation, 1998–2010
| |
|
Primary analyses INSURE failure vs. INSURE success |
Secondary analyses Long MV vs. INSURE success |
||||
|---|---|---|---|---|---|---|---|
| Predictors | INSURE success, n (%) (n = 100) | INSURE failure, n (%) (n = 33) | Crude OR | Adjusted OR (95% CI) 1 | Long MV, n (%) (n = 158) | Crude OR | Adjusted OR (95% CI) 1 |
| Gestational age2 |
|
|
|
|
|
|
|
| 30 + 0 – 31 + 6 weeks (base) |
34 (34) |
3 (9) |
1.0 |
1.0 |
11 (7) |
1.0 |
1.0 |
| 28 + 0 – 29 + 6 weeks |
40 (40) |
16 (49) |
4.5 |
4.8 (1.3–18.0)* |
34 (22) |
2.6 |
3.1 (1.3–7.5)* |
| 26 + 0 – 27 + 6 weeks |
18 (18) |
8 (24) |
5.0 |
4.9 (1.1–21.2)* |
59 (37) |
10.1 |
11.4 (4.6–28.6)* |
| – 25 + 6 weeks |
8 (8) |
6 (18) |
8.5 |
9.9 (1.8–55.6)* |
54 (34) |
20.9 |
26.3 (9.5–72.5)* |
| Birth weight <1000 g2 |
27 (27) |
10 (30) |
1.2 |
0.3 (0.1–1.2) |
105 (67) |
5.5 |
1.6 (0.8–3.3) |
| Small for gestational age2 |
42 (42) |
12 (36) |
0.8 |
0.9 (0.4–2.0) |
64 (41) |
1.0 |
1.3 (0.7–2.3) |
| Gender (male)2 |
57 (57) |
19 (58) |
1.0 |
1.4 (0.6–3.2) |
97 (61) |
1.2 |
1.4 (0.7–2.6) |
| Umbilical cord pH <7.35 |
26 (35) |
6 (24) |
0.6 |
0.7 (0.2–2.1) |
42 (36) |
1.0 |
1.1 (0.5–2.4) |
| Umbilical cord SBE < -3 mmol/l6 |
18 (26) |
5 (24) |
0.9 |
0.6 (0.2–2.0) |
46 (42) |
2.0 |
1.3 (0.6–2.8) |
| Apgar at 1 minute <72 |
30 (30) |
8 (25) |
0.8 |
0.5 (0.2–1.3) |
76 (48) |
2.2 |
1.7 (0.9–3.3) |
| Apgar at 5 minutes <72 |
4 (4) |
2 (6) |
1.6 |
1.4 (0.2–10.6) |
23 (15) |
4.1 |
4.7 (1.0–20.9)* |
| Temp at admission to NICU <35.5°C3 |
13 (14) |
4 (14) |
1.0 |
0.7 (0.2–2.7) |
36 (25) |
2.0 |
1.1 (0.5–2.7) |
| Surfactant given <5 hours after birth2 |
24 (24) |
13 (39) |
2.1 |
1.3 (0.5–3.5) |
104 (66) |
6.1 |
3.3 (1.7–6.2)* |
| a/A-ratio <0.204 |
33 (34) |
5 (17) |
0.4 |
0.6 (0.2–1.8) |
38 (31) |
0.9 |
1.3 (0.6–2.7) |
| FiO2 > 0.503 |
31 (33) |
9 (29) |
0.8 |
1.3 (0.5–3.6) |
74 (50) |
2.0 |
2.7 (1.3–5.3)* |
| pO2 < 7.5 kPa (~56 mmHg)5 |
17 (20) |
5 (17) |
0.8 |
0.8 (0.2–2.9) |
28 (26) |
1.4 |
1.1 (0.5–2.6) |
| pCO2 > 7 kPa (~53 mmHg)4 |
16 (18) |
10 (33) |
2.2 |
2.0 (0.7–5.8) |
62 (50) |
4.4 |
4.3 (1.9–9.6)* |
| pH <7.36 |
30 (43) |
13 (54) |
1.5 |
1.8 (0.7–4.9) |
65 (67) |
2.6 |
3.9 (1.7–8.8)* |
| SBE < -3 mmol/l6 |
20 (29) |
6 (25) |
0.8 |
0.6 (0.2–1.9) |
48 (49) |
2.4 |
1.7 (0.7–3.8) |
| Hemoglobin <8.5 mmol/l6 |
2 (3) |
5 (21) |
8.6 |
5.1 (1.0–25.8)* |
14 (15) |
5.8 |
4.8 (0.7–34.7) |
| Lactate >2.5 mmol/l6 |
25 (37) |
6 (25) |
0.6 |
0.6 (0.2–1.9) |
54 (59) |
2.4 |
2.7 (1.3–5.7)* |
| Mean blood pressure < gestational age6 |
9 (13) |
2 (12) |
0.9 |
1.0 (0.2–6.9) |
16 (17) |
1.4 |
1.7 (0.6–5.2) |
| Inotropes prior to intubation2 |
2 (2) |
1 (3) |
1.5 |
0.9 (0.2–5.2) |
17 (11) |
5.9 |
8.8 (1.2–66.7)* |
| Nulliparity2 |
59 (60) |
23 (72) |
1.7 |
1.8 (0.7–4.8) |
87 (58) |
0.9 |
0.9 (0.5–1.6) |
| Multiple pregnancy2 |
45 (45) |
16 (48) |
1.2 |
0.9 (0.4–2.1) |
66 (42) |
0.9 |
0.6 (0.3–1.1) |
| Preeclampsia3 |
24 (26) |
8 (25) |
0.9 |
1.2 (0.4–3.2) |
18 (12) |
0.4 |
0.4 (0.2–0.8)* |
| Prolonged rupture of membranes3 |
8 (8) |
1 (3) |
0.4 |
0.2 (0.0–2.2) |
16 (11) |
1.4 |
1.1 (0.4–3.4) |
| Maternal age at delivery >30 years2 |
48 (48) |
16 (48) |
1.0 |
1.3 (0.5–3.0) |
86 (55) |
1.3 |
1.6 (0.9–3.1) |
| No antenatal steroids2 |
9 (9) |
4 (13) |
1.4 |
1.4 (0.4–5.4) |
14 (9) |
1.0 |
0.8 (0.3–2.0) |
| Cesarean delivery (vs. vaginal)2 | 72 (72) | 23 (70) | 0.9 | 1.5 (0.6–4.0) | 95 (60) | 0.6 | 1.0 (0.5–1.9) |
Abbreviations: a/A-ratio, arterial to alveolar oxygen tension ratio; FiO2, fraction of inspired oxygen; long MV, mechanical ventilation for more than 24 hours; pCO2, partial pressure of carbon dioxide; pO2, partial pressure of oxygen; SBE, standard base excess; temp, temperature.
*P < 0.05.
1Adjusted for gestational age, gender, and birth year using robust standard error correction for clustering. Gestational age was adjusted for gender and birth year. Gender was adjusted for gestational age and birth year.
Percentage of missing values for each predictor: 2≤ 5%, 3≤ 10%, 4≤ 20%, 5≤ 30%, and 6≤ 40%.