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Multicenter Study
. 2023 Jun;19(6):557-567.
doi: 10.1007/s12519-022-00591-9. Epub 2022 Aug 11.

Characteristics of home oxygen therapy for preterm infants with bronchopulmonary dysplasia in China: results of a multicenter cohort study

Wen-Xing Jiang #  1 , Yan-Chen Wang #  2 , Hong-Xia Song  3 , Mi Xiao  3 , Fan He  1 , Si-Yuan Jiang  2   4 , Xin-Yue Gu  2 , Jian-Hua Sun  5 , Yun Cao  2   4 , Wen-Hao Zhou  2   4 , Shoo Kim Lee  6   7 , Li-Ping Chen  8 , Li-Yuan Hu  9 ; Chinese Neonatal Network
Collaborators, Affiliations
Multicenter Study

Characteristics of home oxygen therapy for preterm infants with bronchopulmonary dysplasia in China: results of a multicenter cohort study

Wen-Xing Jiang et al. World J Pediatr. 2023 Jun.

Abstract

Background: Home oxygen therapy (HOT) is indicated upon discharge in some preterm infants with severe bronchopulmonary dysplasia (BPD). There is a lack of evidence-based consensus on the indication for HOT among these infants. Because wide variation in the institutional use of HOT exists, little is known about the role of regional social-economic level in the wide variation of HOT.

Methods: This was a secondary analysis of Chinese Neonatal Network (CHNN) data from January 1, 2019 to December 31, 2019. Infants at gestational ages < 32 weeks, with a birth weight < 1500 g, and with moderate or severe BPD who survived to discharge from tertiary hospitals located in 25 provinces were included in this study. Infants with major congenital anomalies and those who were discharged against medical advice were excluded.

Results: Of 1768 preterm infants with BPD, 474 infants (26.8%) were discharged to home with oxygen. The proportion of HOT use in participating member hospitals varied from 0 to 89%, with five of 52 hospitals' observing proportions of HOT use that were significantly greater than expected, with 14 hospitals with observing proportions significantly less than expected, and with 33 hospitals with appropriate proportions. We noted a negative correlation between different performance groups of HOT and median GDP per capita (P = 0.04).

Conclusions: The use of HOT varied across China and was negatively correlated with the levels of provincial economic levels. A local HOT guideline is needed to address the wide variation in HOT use with respect to different regional economic levels in countries like China.

Keywords: Bronchopulmonary dysplasia; Chinese Neonatal Network; Gross domestic product; Home oxygen therapy; Preterm infants.

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Conflict of interest statement

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. Shoo Kim Lee is a member of the Editorial Board for World Journal of Pediatrics. The paper was handled by the other Editors and has undergone a rigorous peer-review process. Author Shoo Kim Lee was not involved in the journal’s review or decisions making of this manuscript.

Figures

Fig.1
Fig.1
Flow diagram for the study
Fig. 2
Fig. 2
Institutional variation of home oxygen therapy. a The proportion of home oxygen therapy in participating NICUs of the Chinese Neonatal Network; b The “Funnel” plot of home oxygen therapy
Fig. 3
Fig. 3
Relationship between institutional home oxygen therapy and provincial economic level. a Correlation between indirectly standardized ratio of home oxygen therapy and Per capita GDP of provinces; b The tendency of GDP per capita among different performance groups of home oxygen therapy
See this image and copyright information in PMC

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