Early chest radiographs in very low birth weight babies receiving corticosteroids for lung disease.
We set out to determine whether chest radiographs obtained in premature infants between 9-16 days of age are predictive for the development of chronic lung disease of the newborn (CLD). This was a prospective cohort study. The study included 40 babies who were enrolled in a randomized trial of corticosteroid therapy for the prevention of CLD. Chest radiographs were obtained for clinical indications between 9-16 and 25-35 days of age. All chest radiographs were assessed by a single pediatric radiologist who was unaware of the treatment allocation and who used a previously published scoring system devised by Weinstein et al. [Pediatr Pulmonol 1994;18:284-289]. The radiographic score at 9-16 days correlated well with the radiographic score at 25-35 days of age (correlation coefficient, 0.69, P < or = 0.001). The scores at 9-16 days were significantly higher in those babies who had CLD at 28 days postnatal age (PNA) (P = 0.03) and at 36 weeks postmenstrual age (PMA) (P = 0.002). Using a receiver-operator characteristic curve, we have determined that for a radiographic score of 3 or greater at 9-16 days, the sensitivity for CLD was 0.64, and specificity was 0.84. We conclude that a chest radiograph taken between 9-16 days may help predict which at-risk preterm infants will develop CLD.
Clark
P W
PW
Departments of Paediatrics and Radiology, National Women's Hospital, Auckland, New Zealand.
Bloomfield
F H
FH
Harding
J E
JE
Teele
R L
RL
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000517:prevention & control; D008297:Male; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic; D012307:Risk Factors; D012680:Sensitivity and Specificity
D000305:Adrenal Cortex Hormones