Table I.
Maternal, infant and hospital factors associated with home oxygen use in California 2008 – 2016.*
| Factor | Level | n | Oxygen at Discharge (%) | P-value |
|---|---|---|---|---|
| MATERNAL FACTORS | ||||
| Maternal race and ethnicity | Black | 996 | 51% | 0.0273 |
| Hispanic | 3707 | 47% | ||
| White | 2000 | 44% | ||
| Asian, Native Hawaiian, Pacific Islander | 910 | 47% | ||
| Native American or Other | 200 | 46% | ||
| Cesarean delivery | Yes | 5829 | 46% | 0.0259 |
| No | 2017 | 49% | ||
| Spontaneous labor | Yes | 5359 | 48% | 0.0001 |
| No | 2471 | 44% | ||
| Bleeding / Abruption/ Previa | Yes | 1808 | 51% | <0.0001 |
| No | 6031 | 46% | ||
| INFANT FACTORS | ||||
| Birth weight | 500g or less | 207 | 63% | <0.0001 |
| 501 – 750g | 2521 | 57% | ||
| 751 – l000g | 2688 | 44% | ||
| 1001 – 1250g | 1415 | 37% | ||
| 1251 – 1500g | 682 | 35% | ||
| 1501g + | 333 | 38% | ||
| Gestational age | 24 or less | 1640 | 61% | <0.0001 |
| 25 | 1319 | 53% | ||
| 26 | 1312 | 48% | ||
| 27 | 1117 | 40% | ||
| 28 | 949 | 39% | ||
| 29 | 667 | 36% | ||
| 30 | 513 | 35% | ||
| 31 | 329 | 30% | ||
| Number of transfers before discharging to home | 0 | 5270 | 36% | <0.0001 |
| 1 | 1589 | 65% | ||
| 2 | 847 | 72% | ||
| 3 + | 140 | 84% | ||
| Transfer happened within 7 days of birth | Yes | 1327 | 63% | <0.0001 |
| No | 6459 | 43% | ||
| Nosocomial infection | Yes | 1675 | 56% | <0.0001 |
| No | 6166 | 44% | ||
| NICU length of stay | 79 Days Or Less | 2005 | 38% | <0.0001 |
| 80 – 98 | 2003 | 40% | ||
| 99 – 119 | 1877 | 49% | ||
| 120 + | 1961 | 61% | ||
| Days on ventilator | 4 Or Less | 2752 | 33% | <0.0001 |
| 5 – 16 | 1696 | 45% | ||
| 17 – 35 | 1703 | 50% | ||
| 36 + | 1695 | 67% | ||
| Breast milk provided at discharge | Yes | 4458 | 45% | 0.0029 |
| No | 3387 | 49% | ||
| Surfactant use | Yes | 6819 | 49% | <0.0001 |
| No | 1022 | 34% | ||
| PDA ligation | Yes | 1853 | 62% | <0.0001 |
| No | 5986 | 42% | ||
| NEC | Yes | 549 | 58% | <0.0001 |
| No | 7296 | 46% | ||
| Nitric oxide use | Yes | 550 | 59% | <0.0001 |
| No | 7295 | 46% | ||
| Delivery room oxygen support | None | 134 | 33% | <0.0001 |
| Oxygen/CPAP | 1033 | 35% | ||
| Bag/Mask/NIPPV | 1386 | 42% | ||
| Endotracheal Intubation | 4541 | 50% | ||
| Epinephrine or Cardiac Medications | 752 | 56% | ||
| Post delivery room respiratory support | Oxygen/High Flow Nasal Cannula | 108 | 23% | <0.0001 |
| CPAP | 374 | 31% | ||
| NIPPV | 235 | 26% | ||
| Intubated Mechanical Ventilation | 3179 | 39% | ||
| Oscillator | 3950 | 56% | ||
| PMA in weeks at discharge | 38 Or Less | 1939 | 45% | <0.0001 |
| 39 – 40 | 2176 | 38% | ||
| 41 – 42 | 1497 | 42% | ||
| 43 + | 1766 | 56% | ||
| HOSPITAL FACTORS | ||||
| Birth NICU CCS level | Non-CCS or Intermediate | 1214 | 55% | <0.0001 |
| Community | 4664 | 46% | ||
| Regional | 1968 | 44% | ||
| Discharging NICU CCS level | Non-CCS or Intermediate | 243 | 49% | <0.0001 |
| Community | 4464 | 42% | ||
| Regional | 3139 | 54% | ||
| Discharging NICU average volume (hospital quintiles) | 47 Or Less | 240 | 55% | <0.0001 |
| 48 – 75 | 536 | 34% | ||
| 76 – 107 | 1042 | 41% | ||
| 108 – 189 | 2040 | 48% | ||
| 190 + | 3988 | 49% | ||
| % BPD patients discharged across years (hospital quartiles) | 11.9% or Less | 2127 | 48% | <0.0001 |
| 11.9 – 14.5% | 1849 | 36% | ||
| 14.5 – 16.8% | 1962 | 50% | ||
| 16.8 + | 1908 | 53% | ||
| Birth Year | 2008 | 455 | 50% | <0.0001 |
| 2009 | 426 | 48% | ||
| 2010 | 444 | 47% | ||
| 2011 | 339 | 42% | ||
| 2012 | 362 | 42% | ||
| 2013 | 380 | 44% | ||
| 2014 | 438 | 47% | ||
| 2015 | 422 | 53% | ||
| 2016 | 406 | 49% | ||
*
Table 1 presents factors which were significantly associated with home oxygen use in bivariate analysis. Other factors considered that were not significant at p<0.05 level included prenatal care, antenatal steroids, gestational diabetes, maternal hypertension, multiple pregnancy, maternal age, small for gestational age, sex.
Abbreviations: NICU, neonatal intensive care unit; PDA, patent ductus arteriosus; CPAP, continuous positive airway pressure; NIPPV, nasal intermittent positive pressure ventilation; CCS, California children’s services; BPD, bronchopulmonary dysplasia; PMA, post-menstrual age.