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. 2021 Aug;41(8):1943-1950.
doi: 10.1038/s41372-021-01095-6. Epub 2021 May 24.

New BPD-prevalence and risk factors for bronchopulmonary dysplasia/mortality in extremely low gestational age infants ≤28 weeks

Odattil Geetha  1   2   3   4 , Victor Samuel Rajadurai  5   6   7   8 , Amudha Jayanthi Anand  5   6   7   8 , Rowena Dela Puerta  5 , Bin Huey Quek  5   6   7   8 , Poh Choo Khoo  5   6   7   8 , Mei Chien Chua  5   6   7   8 , Pratibha Agarwal  6   7   8   9
Affiliations

New BPD-prevalence and risk factors for bronchopulmonary dysplasia/mortality in extremely low gestational age infants ≤28 weeks

Odattil Geetha et al. J Perinatol. 2021 Aug.

Abstract

Objective: To evaluate prevalence and risk factors of moderate-severe Bronchopulmonary dysplasia (BPD)/Death in extremely low gestation age neonates (ELGANs).

Study design: Study of 266 ELGANs born at gestational age (GA) ≤ 28 weeks (w). Primary Outcome measure-composite outcome of moderate-severe BPD/Death using the National Institute of Child Health and Human Development NICHD's (2001) BPD definition.

Result: Cohort's mean GA and birth-weight (BW) were 25.3 ± 1.4w and 724 ± 14 g respectively with an overall mortality of 19% and moderate-severe BPD of 67%. Prevalence of moderate-severe BPD/death decreased significantly with increasing GA (86-93%) at 23-24 w; to <60% at 27-28w (OR 0.63; 95% CI; 0.52-0.77). On univariate analysis, other risk factors included BW(OR 1.005; 95% CI; 1.003-1.007), Sepsis (OR 2.9; 95% CI, 1.3-6.4), PDA needing treatment (OR 2.2; 95% CI, 1.3-3.9); air leaks (OR 2.7; 95% CI; 1.02-7.3) FiO2 requirement >25%(OR 1.06; 95% CI; 1.01-1.11); and mechanical ventilation(MV) on Day7 (OR5.5; 95% CI; 2.8-10.8). Only need for Day7 MV was independently predictive of composite outcome (OR1.97; 95% CI; 1.3-3.1).

Conclusion: Risk factor identification will enable initiatives to implement lung protective strategies and develop prospective models for BPD prediction and prognostication.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Summary of ELBW (extremely low birth weight) infants born during the study period.
Flow diagram of ELBW infants born between January 2012 till December 2015.
Fig. 2
Fig. 2. Histogram showing the three possible outcomes (No/Mild BPD, Moderate/Severe BPD and Death) of ELBW infants as per gestational age.
Mortality and BPD stratified by geimational age in infants ≤28 weeks.
See this image and copyright information in PMC

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