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.

中文翻译：

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在患有呼吸窘迫综合征的更成熟和更大的早产儿中与表面活性剂相关的结果。

目的 研究非适应证表面活性剂对诊断为呼吸窘迫综合征 (RDS) 的更成熟和更大的早产儿死亡率和发病率的影响。研究设计 对 30-36 周出生、出生体重 > 2 kg 且诊断为 RDS 的早产儿的队列研究。我们比较了接触表面活性剂与未接触表面活性剂的婴儿之间的死亡率和发病率的几率。我们使用治疗效果模型来平衡组之间的协变量。结果 在纳入的 54,964 名婴儿中，25,278 (46%) 名暴露于表面活性剂。在未经调整的分析中，暴露组的死亡率和发病率更高。在用双重稳健的治疗效果模型进行调整后，我们发现表面活性剂对死亡率或发病率没有显着的治疗效果。