Differences in Possible Risk Factors, Treatment Strategies, and Outcomes of Neonatal Pneumothorax in Preterm and Term Infants.

ABSTRACT

OBJECTIVE: The study aimed to compare the risk factors, treatment strategies, and early outcomes of symptomatic neonatal pneumothorax (NP) between preterm and term newborns. MATERIALS AND METHODS: This retrospective cross-sectional study was conducted in a neonatal intensive care unit between 2015 and 2022, consisting of hospitalized neonates with symptomatic NP. The cases were divided into three groups according to their gestational ages <340/7 (group 1), 340/7-366/7 (group 2), and ≥370/7 weeks (group 3). Risk factors, treatment strategies, and mortality rates of the study groups were compared using Kruskal-Wallis analysis. RESULTS: Fifty-nine infants with a diagnosis of symptomatic NP were included in the study. The number of participants was as follows 25 (42.3%) in group 1, 18 (30.5%) in group 2, and 16 (27.1%) in group 3. The need of delivery room (DR) resuscitation was significantly higher in group 1 (40%, P = .003). The surfactant administration rate was significantly higher in group 1 when compared to group 2 and group 3 (68% vs. 22% and 19%, respectively), P < .001. Similarly, the invasive mechanical ventilation percentage was significantly higher in group 1 than group 2 and group 3, P = .014. However, compared to group 3 (63%), the percentage of chest drain insertion (CDI) need was significantly higher in group 1 (96%) and group 2 (89%) (P = .014). CONCLUSION: Exposure to DR resuscitation and the need for surfactant are the most common risk factors for NP in preterm infants. Although oxygen and/or needle aspiration treatments are less invasive in symptomatic NP, the improvement rate without CDI is very low in preterm infants born before 34 weeks of gestational age. Cite this article as Tandircioglu U, Koral Ü, Güzoglu N, Alan S, Aliefendioglu D. Differences in possible risk factors, treatment strategies, and outcomes of neonatal pneumothorax in preterm and term infants. Turk Arch Pediatr. 2024;59(1)87-92.