{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:01:08Z","timestamp":1781067668086,"version":"3.54.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate determinants of respiratory support duration and construct an interpretable weaning prediction model for late preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study enrolled 365 late preterm infants (gestational age 34\u2009+\u20090\u201336\u2009+\u20096 weeks). Respiratory support duration (days) was the survival outcome, with successful weaning as the event. After Pearson correlation screening (|r|\u2009&amp;gt;\u20090.75 excluded), LASSO-Cox regression (10-fold cross-validation) selected predictors, followed by multivariable Cox modeling. Discrimination was assessed by C-index and time-dependent AUC at days 3, 5, and 8, with optimism-corrected bootstrap validation. Calibration was evaluated using calibration curves, Brier scores, and decision curve analysis. SHAP analysis quantified feature contributions on the log-hazard scale. Sensitivity analyses verified robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multiple pregnancy (HR\u2009=\u20091.289, 95% CI: 1.038\u20131.601,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.022), superoxide dismutase (SOD) (HR\u2009=\u20091.014, 95% CI: 1.009\u20131.019,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and albumin-to-globulin ratio (A\/G) (HR\u2009=\u20091.130, 95% CI: 1.001\u20131.275,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.049) were risk factors. Nasal continuous positive airway pressure (NCPAP) (HR\u2009=\u20090.703, 95% CI: 0.564\u20130.878,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002), lymphocyte percentage (LYM_PC) (HR\u2009=\u20090.987, 95% CI: 0.978\u20130.997,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008), and lactate dehydrogenase (LDH) (HR\u2009=\u20090.991, 95% CI: 0.984\u20130.998,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.013, per 10-unit increase) were protective factors. Pulmonary surfactant showed no association (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.652). The model achieved a C-index of 0.677 (optimism-corrected 0.661) and td-AUC of 0.732, 0.769, and 0.782 at days 3, 5, and 8. Calibration was acceptable, DCA showed net benefit at day 5, and SHAP identified SOD, NCPAP, and LYM_PC as primary drivers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The LASSO-Cox nomogram demonstrated moderate-to-good discrimination. Multiple pregnancy and elevated SOD are warning signs for prolonged oxygen dependency, while early NCPAP can shorten respiratory support. Nomogram visualization with SHAP interpretability provides a transparent basis for individualized weaning assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1832233","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:31:32Z","timestamp":1781065892000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for prolonged respiratory support in late preterm infants: a LASSO-Cox regression analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yu","family":"Huang","sequence":"first","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Shuang","family":"Bao","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Sun","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Li","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Fai","family":"Zhang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1542\/peds.2006-0018","article-title":"Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the national institute of child health and human development","volume":"118","author":"Raju","year":"2006","journal-title":"Pediatrics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1097\/MOP.0000000000000863","article-title":"Ventilator-induced lung injury in the neonate: still a challenging problem","volume":"32","author":"De Luca","year":"2020","journal-title":"Curr Opin Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1002\/(SICI)1097-0258(19970228)16:4%3C385::AID-SIM380%3E3.0.CO;2-3","article-title":"The lasso method for variable selection in the cox model","volume":"16","author":"Tibshirani","year":"1997","journal-title":"Stat Med"},{"key":"B4","doi-asserted-by":"crossref","first-page":"W1","DOI":"10.7326\/M14-0698","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): explanation and elaboration","volume":"162","author":"Collins","year":"2015","journal-title":"Ann Intern Med"},{"key":"B5","first-page":"4765","article-title":"A unified approach to interpreting model predictions","volume":"30","author":"Lundberg","year":"2017","journal-title":"Adv Neural Inf Process Syst"},{"key":"B6","first-page":"284","article-title":"Analysis of respiratory complications and risk factors in late preterm infants","volume":"57","author":"Li","year":"2019","journal-title":"Chin J Pediatr"},{"key":"B7","first-page":"845","article-title":"Application progress of machine learning in neonatal disease prognosis prediction [in Chinese]","volume":"60","author":"Wang","year":"2022","journal-title":"Chin J Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"m441","DOI":"10.1136\/bmj.m441","article-title":"Calculating the sample size required for developing a clinical prediction model","volume":"368","author":"Riley","year":"2020","journal-title":"Br Med J"},{"key":"B9","first-page":"15","article-title":"Analysis of complications and prognosis in multiple pregnancy preterm infants","volume":"36","author":"Liu","year":"2021","journal-title":"Chin J Neonatol"},{"key":"B10","first-page":"208","article-title":"Twin pregnancy and perinatal outcomes: a systematic review and meta-analysis","volume":"57","author":"D'Antonio","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B11","first-page":"512","article-title":"Research progress on the pathogenesis of oxidative stress and bronchopulmonary dysplasia in neonates [in Chinese]","volume":"58","author":"Chen","year":"2020","journal-title":"Chin J Pediatr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1386695","DOI":"10.3389\/fneur.2024.1386695","article-title":"Hyperbaric oxygen therapy for the treatment of hypoxic\/ischemic injury upon perinatal asphyxia: neuroinflammation and oxidative stress as targets for clinical improvement","volume":"15","author":"Mielecki","year":"2024","journal-title":"Front Neurol"},{"key":"B13","first-page":"321","article-title":"Expert consensus on prevention and treatment of neonatal respiratory distress syndrome (2023 edition)","volume":"61","year":"2023","journal-title":"Chin J Pediatr"},{"key":"B14","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.prrv.2020.02.003","article-title":"Late preterm infants: burden of respiratory disease and use of non-invasive respiratory support","volume":"36","author":"Kotecha","year":"2020","journal-title":"Paediatr Respir Rev"},{"key":"B15","first-page":"112","article-title":"Research progress on the relationship between immune-inflammatory indicators and respiratory diseases in preterm infants [in Chinese]","volume":"49","author":"Zhang","year":"2022","journal-title":"Int J Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1522868","DOI":"10.3389\/fneur.2025.1522868","article-title":"Interpretable prediction of stroke prognosis: sHAP for SVM and nomogram for logistic regression","volume":"16","author":"Guo","year":"2025","journal-title":"Front Neurol"},{"key":"B17","first-page":"789","article-title":"Evaluation value of serum albumin to globulin ratio in neonatal disease prognosise","volume":"21","author":"Wang","year":"2019","journal-title":"Chin J Contemp Pediatr"},{"key":"B18","first-page":"743","article-title":"Application progress of LASSO cox regression model in medical prognosis research","volume":"55","author":"Zhang","year":"2021","journal-title":"Chin J Prev Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1366913","DOI":"10.3389\/fped.2024.1366913","article-title":"Construction and evaluation of a risk model for adverse outcomes of necrotizing enterocolitis based on LASSO-cox regression","volume":"12","author":"Zhang","year":"2024","journal-title":"Front Pediatr"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1832233\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:31:44Z","timestamp":1781065904000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1832233\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":19,"alternative-id":["10.3389\/fped.2026.1832233"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1832233","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"article-number":"1832233"}}