Developmental outcomes at the age of two years for very premature babies managed with nasal prong continuous positive airway pressure

Abstract

To describe the developmental progress of very premature babies at the age of 2 years, who were managed in an era where nasal prong continuous positive airway pressure (CPAP) was the preferred method for the management of initial respiratory disease. Two groups of very premature babies of <32 weeks gestation were compared, the first being managed with an intubation and mandatory ventilation approach, and the second being managed with a CPAP approach. The groups are compared with regard to the presence of brain injury, retinopathy and requiring discharge home on oxygen and then at 2 years, for language impairment, non-ambulatory cerebral palsy and significant developmental delay. The study is designed as an audit of data collected prospectively and longitudinally for babies born from 1998 to 2002. A significant number of babies were successfully managed on CPAP in the second era and significantly fewer received post-natal steroids. The number being discharged home on oxygen, brain injury and retinopathy were similar in the two groups. Developmental outcome assessed at 2 years of age was the same in both eras. A CPAP approach to the management of initial respiratory disease in premature babies of less than 32 weeks gestation at birth is associated with no measurable developmental advantage or disadvantage at 2 years of age.