Adam Beaton, Prithvi Sendi, Paul A. Martinez, Balagangadhar R. Totapally
Cohen Children’s Medical Center. Nicklaus Children’s Hospital. Florida International University.
United States
Journal of Neonatal-Perinatal Medicine
J Neonatal Perinatal Med 2025; 17: 846-857
DOI: 10.1177/19345798241308491
Abstract
Objectives: To describe the prevalence, risk factors, and outcomes for neonatal air leak syndrome and its subtypes (pneumothorax, pneumomediastinum, pneumopericardium, pulmonary interstitial emphysema, and pneumoperitoneum), evaluate variables associated with the development of air leak, and analyze the national trend of neonatal air leak syndrome in the United States.
Methods: A retrospective cross-sectional analysis of neonates was performed using the Kids’ Inpatient Database. Univariate and multivariable analyses were used to compare neonates with and without air leak syndrome and its subtypes using the 2016 and 2019 data. Data from 1997 to 2019 were used for trend analysis.
Results: Of 7.7 million neonatal discharges, 41,814 developed air leak syndrome (5.41/1,000 discharges) in 2016 and 2019, with a mortality rate of 7.2%. Pneumothorax was the most common air leak syndrome (4.3/1,000 discharges). The risk of air leak syndrome increased with decreasing gestational age on univariate analysis. On multivariable analysis, gestational age had a variable effect on developing air leaks depending on the type of air leak syndrome. The presence of meconium aspiration syndrome, congenital diaphragmatic hernia, persistent pulmonary hypertension, and the use of invasive mechanical ventilation were associated with an increased risk of air leak syndrome. There was an increased linear trend in neonatal air leak syndrome prevalence in the United States from 1997 to 2019.
Conclusions: Air leak syndrome remains a serious and significant issue among the neonatal population and is associated with high morbidity and mortality. We present a national prevalence and outcomes of various neonatal air leak syndromes in the United States.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Class III. Pulmonary Hypertension Associated with Lung Disease
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Symptoms and Findings Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes