Characteristics and outcomes of preterm neonates according to number of doses of surfactant received Academic Article uri icon

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  • OBJECTIVES: To identify characteristics and outcomes of infants who received multiple doses of surfactant vs those who received one dose or none. STUDY DESIGN: In this retrospective study, we included neonates of 22-28 weeks' gestation admitted to NICUs in the Canadian Neonatal Network. Patients were divided into three groups: no surfactant, single dose, and multiple doses. The primary outcome was a composite of mortality or any of the major morbidities, including severe neurological injury, bronchopulmonary dysplasia, or ≥stage 3 retinopathy of prematurity. RESULTS: Of 8024 eligible neonates, 2461 (31%) did not receive surfactant, 3545 (44%) received one dose, and 2018 (25%) received >1 dose. Receiving one or more doses of surfactant was associated with significantly higher adjusted odds of mortality or major morbidities in a dose-dependent manner. CONCLUSIONS: Receiving one or more doses of surfactant was associated with adverse neonatal outcomes. Receipt of more than one dose may reflect underlying severe lung immaturity.


  • Coshal, Hanita
  • Mukerji, Amit
  • Lemyre, Brigitte
  • Ng, Eu-gene
  • Alvaro, Ruben
  • Ethier, Guillaume
  • Yoon, Eugene W
  • Beltempo, Marc
  • Shah, Prakesh S

publication date

  • January 2021