Wesley Jackson1, Genevieve Taylor2, Nicolas A Bamat3, Kanecia Zimmerman4,5, Reese Clark6, Daniel K Benjamin7, Matthew M Laughon2, Rachel G Greenberg4,5, Christoph P Hornik4,5. 1. Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, 101 Manning Drive, Room N4051, CB #7596, Chapel Hill, NC, 27599, USA. wesley.jackson@unc.edu. 2. Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, 101 Manning Drive, Room N4051, CB #7596, Chapel Hill, NC, 27599, USA. 3. Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 4. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA. 5. Duke Clinical Research Institute, Durham, NC, USA. 6. Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA. 7. Department of Economics, Clemson University, Clemson, SC, USA.
Abstract
OBJECTIVE: Examine the effect of off-label surfactant on mortality and morbidity in more mature and larger premature infants diagnosed with respiratory distress syndrome (RDS). STUDY DESIGN: Cohort study of premature infants born at 30-36 weeks, birth weight > 2 kg, and a diagnosis of RDS. We compared the odds of mortality and morbidity between infants who were exposed vs unexposed to surfactant. We used a treatment effects model to balance covariates between groups. RESULTS: Of 54,964 included infants, 25,278 (46%) were exposed to surfactant. The frequency of mortality and morbidities were higher in the exposed group in unadjusted analyses. Following adjustment with a doubly robust treatment effects model, we found no significant treatment effect of surfactant on mortality or morbidity. CONCLUSION: Surfactant exposure is not associated with reduced or increased mortality or morbidity in more mature premature infants with RDS.
OBJECTIVE: Examine the effect of off-label surfactant on mortality and morbidity in more mature and larger premature infants diagnosed with respiratory distress syndrome (RDS). STUDY DESIGN: Cohort study of premature infants born at 30-36 weeks, birth weight > 2 kg, and a diagnosis of RDS. We compared the odds of mortality and morbidity between infants who were exposed vs unexposed to surfactant. We used a treatment effects model to balance covariates between groups. RESULTS: Of 54,964 included infants, 25,278 (46%) were exposed to surfactant. The frequency of mortality and morbidities were higher in the exposed group in unadjusted analyses. Following adjustment with a doubly robust treatment effects model, we found no significant treatment effect of surfactant on mortality or morbidity. CONCLUSION: Surfactant exposure is not associated with reduced or increased mortality or morbidity in more mature premature infants with RDS.
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