Outcomes associated with surfactant in more mature and larger premature infants with respiratory distress syndrome.

OBJECTIVE

Examine the effect of off-label surfactant on mortality and morbidity in more mature and larger premature infants diagnosed with respiratory distress syndrome (RDS).

STUDY

DESIGN

Cohort study of premature infants born at 30-36 weeks, birth weight > 2 kg, and a diagnosis of RDS. We compared the odds of mortality and morbidity between infants who were exposed vs unexposed to surfactant. We used a treatment effects model to balance covariates between groups.

RESULTS

Of 54,964 included infants, 25,278 (46%) were exposed to surfactant. The frequency of mortality and morbidities were higher in the exposed group in unadjusted analyses. Following adjustment with a doubly robust treatment effects model, we found no significant treatment effect of surfactant on mortality or morbidity.

CONCLUSION

Surfactant exposure is not associated with reduced or increased mortality or morbidity in more mature premature infants with RDS.