{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:03:55Z","timestamp":1791813835167,"version":"4.3.4"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>In 2011, the Neonatal Resuscitation Program (NRP) added consideration of continuous positive airway pressure (CPAP) for spontaneously breathing infants with labored breathing or hypoxia in the delivery room (DR). The objective of this study was to determine if DR-CPAP is associated with symptomatic pneumothorax in infants 35 to 42 weeks\u2019 gestational age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We included (1) a retrospective birth cohort study of neonates born between 2001 and 2015 and (2) a nested cohort of those born between 2005 and 2015 who had a resuscitation call leading to admission to the NICU and did not receive positive-pressure ventilation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>In the birth cohort (n = 200\u2009381), pneumothorax increased after implementation of the 2011 NRP from 0.4% to 0.6% (P &amp;lt; .05). In the nested cohort (n = 6913), DR-CPAP increased linearly over time (r = 0.71; P = .01). Administration of DR-CPAP was associated with pneumothorax (odds ratio [OR]: 5.5; 95% confidence interval [CI]: 4.4\u20136.8); the OR was higher (P &amp;lt; .001) in infants receiving 21% oxygen (OR: 8.5; 95% CI: 5.9\u201312.3; P &amp;lt; .001) than in those receiving oxygen supplementation (OR: 3.5; 95% CI: 2.5\u20135.0; P &amp;lt; .001). Among those with DR-CPAP, pneumothorax increased with gestational age and decreased with oxygen administration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>The use of DR-CPAP is associated with increased odds of pneumothorax in late-preterm and term infants, especially in those who do not receive oxygen in the DR. These findings could be used to clarify NRP guidelines regarding DR-CPAP in late-preterm and term infants.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2019-0756","type":"journal-article","created":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T12:24:01Z","timestamp":1565353441000},"source":"Crossref","is-referenced-by-count":77,"title":["Delivery Room Continuous Positive Airway Pressure and Pneumothorax"],"prefix":"10.1542","volume":"144","author":[{"given":"William","family":"Smithhart","sequence":"first","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra H.","family":"Wyckoff","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mambarambath","family":"Jaleel","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatakrishna","family":"Kakkilaya","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Steven","family":"Brown","sequence":"additional","affiliation":[{"name":"Parkland Health and Hospital System, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern, Dallas, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc P.","family":"Brion","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,9,1]]},"reference":[{"issue":"10","key":"2021121014055416800_B1","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1001\/jama.2015.10244","article-title":"Trends in care practices, morbidity, and mortality of extremely preterm neonates, 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