Perinatal and Early Respiratory Factors Associated with Invasive Mechanical Ventilation in Very Preterm Infants: A Retrospective Cohort Study from Kazakhstan
7 affiliations
- 1Department of Neonatology, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan
- 2JSC “Scientific Center of Obstetrics, Gynecology and Perinatology”, Almaty 050020, Kazakhstan
- 3Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Istanbul Atlas University, Istanbul 34408, Turkey
- 4Zhambyl Regional Perinatal Center, Department of Health of the Akimat of Zhambyl Region, Taraz 080000, Kazakhstan
- 5Department of Children’s Diseases Named After Professor N.A. Barlybayeva, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan
- 6Department of Pediatric Anesthesiology and Intensive Care, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan
- 7Children’s Emergency Medicine Center, Almaty 050040, Kazakhstan
Abstract
Background: Evidence on factors associated with the timing of invasive mechanical ventilation (IMV) among very preterm infants in Central Asia remains limited. Methods: This retrospective cohort study included infants born at 22–30 weeks gestation in two tertiary perinatal centers in Kazakhstan between 2021 and 2025. Analyses were restricted to 381 infants with complete data. IMV initiated during the first week of life was classified as early IMV, and IMV initiated after the first week as late IMV. Separate multivariable logistic regression models were constructed for any, early, and late IMV. Results: Any IMV was recorded in 191 infants (50.1%), including 132 (34.6%) with early IMV and 59 (15.5%) with late IMV. Early IMV was associated with gestational age ≤ 27 weeks (aOR 3.91, 95% CI 1.66–9.22), absence of spontaneous breathing at birth (aOR 151.93, 95% CI 18.26–1263.88), and initial FiO2 > 0.30 (aOR 4.39, 95% CI 1.97–9.77). Complete antenatal corticosteroid exposure was inversely associated with early IMV (aOR 0.38, 95% CI 0.20–0.72). Late IMV was associated with birth weight < 1000 g (aOR 3.51, 95% CI 1.47–8.35) and initial FiO2 > 0.30 (aOR 2.12, 95% CI 1.02–4.39). An initial set CPAP ≥ 12 cmH2O was recorded in 71.9% of infants and was associated with any IMV but not with early or late IMV separately. Conclusions: Early and late IMV were associated with different clinical patterns. These observational associations may support risk assessment but do not establish causal effects of respiratory-support practices.
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BibTeX
@article{alimukhamedov2026perinatal,
title = {{Perinatal and Early Respiratory Factors Associated with Invasive Mechanical Ventilation in Very Preterm Infants: A Retrospective Cohort Study from Kazakhstan}},
author = {Umid Alimukhamedov and Nishankul Bozhbanbayeva and Merih Çetinkaya and Talgat Tolykbayev and Altynay Sadykova and Bekzat Suieubekov and Ulykpan Alseitov},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207879},
url = {https://www.mdpi.com/2077-0383/15/20/7879},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Perinatal and Early Respiratory Factors Associated with Invasive Mechanical Ventilation in Very Preterm Infants: A Retrospective Cohort Study from Kazakhstan
AU - Umid Alimukhamedov
AU - Nishankul Bozhbanbayeva
AU - Merih Çetinkaya
AU - Talgat Tolykbayev
AU - Altynay Sadykova
AU - Bekzat Suieubekov
AU - Ulykpan Alseitov
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207879
UR - https://www.mdpi.com/2077-0383/15/20/7879
AB - Background: Evidence on factors associated with the timing of invasive mechanical ventilation (IMV) among very preterm infants in Central Asia remains limited. Methods: This retrospective cohort study included infants born at 22–30 weeks gestation in two tertiary perinatal centers in Kazakhstan between 2021 and 2025. Analyses were restricted to 381 infants with complete data. IMV initiated during the first week of life was classified as early IMV, and IMV initiated after the first week as late IMV. Separate multivariable logistic regression models were constructed for any, early, and late IMV. Results: Any IMV was recorded in 191 infants (50.1%), including 132 (34.6%) with early IMV and 59 (15.5%) with late IMV. Early IMV was associated with gestational age ≤ 27 weeks (aOR 3.91, 95% CI 1.66–9.22), absence of spontaneous breathing at birth (aOR 151.93, 95% CI 18.26–1263.88), and initial FiO2 > 0.30 (aOR 4.39, 95% CI 1.97–9.77). Complete antenatal corticosteroid exposure was inversely associated with early IMV (aOR 0.38, 95% CI 0.20–0.72). Late IMV was associated with birth weight < 1000 g (aOR 3.51, 95% CI 1.47–8.35) and initial FiO2 > 0.30 (aOR 2.12, 95% CI 1.02–4.39). An initial set CPAP ≥ 12 cmH2O was recorded in 71.9% of infants and was associated with any IMV but not with early or late IMV separately. Conclusions: Early and late IMV were associated with different clinical patterns. These observational associations may support risk assessment but do not establish causal effects of respiratory-support practices.
SN - 2077-0383
ER -