Objective To assess the neurodevelopmental outcomes of preterm neonates who received inhaled nitric oxide (iNO) in the first week of age for hypoxaemic respiratory failure (HRF). Methods In this retrospective cohort study, we included neonates born at <29 weeks gestational age (GA) between January 2010 and December 2018 who had a neurodevelopmental assessment at 18–24 months corrected age (CA) at one of the Canadian Neonatal Follow-Up Network clinics. The primary outcome was neurodevelopmental impairment (NDI). We performed propensity score-matched analysis to compare the outcomes of those who received and did not receive iNO. Results Of the 5612 eligible neonates, 460 (8.2%) received iNO in the first week of age. Maternal age, receipt of antenatal corticosteroids, GA and birth weight were lower in the iNO group compared with the no-iNO group. Neonates in the iNO group had higher illness severity scores and higher rates of preterm prolonged rupture of membranes and were small for GA. Severe brain injury, bronchopulmonary dysplasia and mortality were higher in the iNO group. Of the 4889 survivors, 3754 (77%) neonates had follow-up data at 18–24 months CA. After propensity score matching, surviving infants who received rescue iNO were not associated with higher odds of NDI (adjusted OR 1.34; 95% CI 0.85 to 2.12). Conclusions In preterm neonates <29 weeks GA with HRF, rescue iNO use was not associated with worse neurodevelopmental outcomes among survivors who were assessed at 18–24 months CA. Data are available upon reasonable request.

中文翻译：

---

早产儿第一周接受吸入一氧化氮救援的神经发育结果：队列研究

目的 评估因低氧性呼吸衰竭 (HRF) 在出生第一周接受吸入一氧化氮 (iNO) 的早产儿的神经发育结局。方法 在这项回顾性队列研究中，我们纳入了 2010 年 1 月至 2018 年 12 月期间出生的胎龄 <29 周 (GA) 的新生儿，他们在 18-24 个月校正年龄 (CA) 时在加拿大新生儿随访中心进行了神经发育评估网络诊所。主要结局是神经发育障碍（NDI）。我们进行了倾向评分匹配分析，以比较接受和未接受 iNO 的患者的结果。结果 在 5612 名符合条件的新生儿中，460 名（8.2%）在出生第一周接受了 iNO。与无 iNO 组相比，iNO 组的母亲年龄、产前皮质类固醇的接受情况、GA 和出生体重均较低。iNO 组的新生儿疾病严重程度评分较高，早产胎膜长时间破裂率较高，且 GA 较小。iNO 组的严重脑损伤、支气管肺发育不良和死亡率较高。在 4889 名幸存者中，3754 名 (77%) 新生儿拥有 18-24 个月 CA 的随访数据。倾向评分匹配后，接受 iNO 救援的存活婴儿与更高的 NDI 几率无关（调整后 OR 1.34；95% CI 0.85 至 2.12）。结论 对于 GA 小于 29 周的 HRF 早产儿，在 18-24 个月 CA 时进行评估的幸存者中，使用救援 iNO 与较差的神经发育结果无关。数据可根据合理要求提供。