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UBC Theses and Dissertations

Craniofacial morphology and the use of neonatal non-invasive ventilation therapy He, Don


Objective: A prospective cohort study with the overall objective to characterize the three-dimensional facial morphology of preterm infants over the course of the first 18 months of corrected age, participating in the Neonatal Follow-up Program of B.C. Women’s Hospital in Vancouver, BC. The specific aims of this project are to: 1. Characterize the three-dimensional facial morphology of a cohort of preterm infants at 4, 8 and 18 months of corrected age. 2. Determine the effects of the duration of NIV therapy on facial morphology at 4, 8 and 18 months of corrected age. 3. Evaluate the feasibility, time, adverse events, and minimum effect size to predict an appropriate sample size to improve study design prior to performance of a full scale longitudinal research project. Methods: To achieve this goal, infants reporting for follow-up at 4, 8 and 18 months of age corrected for prematurity will be screened for defined eligibility and imaged with a 3dMD surface-imaging camera, and facial morphometric parameters will be related to anthropometric data at birth and the specific characteristics of respiratory therapy received during the neonatal period or longer. Results: The study obtained 43 facial images: 10 images for the four-month cohort; 13 images for the 8-month cohort; 20 images for the 18-month cohort. The mean gestation age is 26 weeks, birth weight is 822 grams, birth length is 32.6 cm, and birth head circumference is 23.8 cm. The mean NIV therapy duration is 45 days and the mean NICU stay is 101 days. There was statistical significant negative correlation between intercanthal width versus duration of NIV therapy in the 4-month cohort. Conclusion: There were not any statistical significant correlations between the duration of NIV therapy and the linear distances measured in the transverse, vertical and anterior-posterior plane other than the intercanthal width. The duration of NIV therapy did not have any statistical significant correlation with measured facial angles and facial ratios. This pilot study was however not powered to detect a difference. There is overall positive feasibility for acceptability, demand, implementation, practicality, adaptation, integration and expansion of the research project.

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