title: Perinatal risk factors for pneumothorax and morbidity and mortality in very low birth weight infants.
abstract: OBJECTIVE
  To determine the perinatal risk factors for pneumothorax in Very-Low-Birth-Weight (VLBW) infants and the associated morbidity and mortality in this population.
  
  
  METHODS
  Retrospective analysis of data collected prospectively from a cohort of VLBW neonates assisted in our Unit (2006-2013). We included all consecutive in-born patients with ≤ 1500 g, without severe congenital anomalies. Perinatal history, demographics, interventions and clinical outcomes were collected. Associations were evaluated by logistic regression analysis.
  
  
  RESULTS
  During the study period, 803 VLBW infants were assisted in our Unit, of whom 763 were inborn. Ten patients (1.2%) died in delivery room, and 18 (2.2%) with major congenital anomalies were excluded. Finally, 735 (91.5%) neonates were included in the study. Seventeen (2.3%) developed pneumothorax during the first week of life [median (IQR): 2 (1-2) days]. After correcting for GA and other confounders, prolonged rupture of membranes [aOR =1.002 (95% CI 1.000-1.003); p = 0.040] and surfactant administration [aOR = 6.281 (95% CI 1.688-23.373); p = 0.006] were the independent risk factors associated with pneumothorax. Patients with pneumothorax had lower probabilities of survival without major brain damage (MBD): aOR = 0.283 (95% CI = 0.095-0.879); p = 0.029.
  
  
  CONCLUSIONS
  Pneumothorax in VLBW seems to be related to perinatal inflammation and surfactant administration, and it is significantly associated with a reduction in the probabilities of survival without MBD.
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Fermín
authors.initials: F
authors.lastname: García-Muñoz Rodrigo
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Urquía Martí
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Galán Henríquez
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Rivero Rodríguez
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Tejera Carreño
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Molo Amorós
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Cabrera Vega
authors.affiliation: a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez Ramón
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D009017:Morbidity; D011030:Pneumothorax / Q000453:epidemiology* / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Brain damage; Very-Low-Birth-Weight infant; pneumothorax; preterm rupture of membranes; respiratory distress syndrome