Point prevalence, characteristics and treatment variations for preterm infants with bronchopulmonary dysplasia in China: a 'snapshot' study

Abstract

Objective: The incidence of bronchopulmonary dysplasia (BPD) is increasing, but data on its prevalence and management variations remain insufficient in China. The study aims to investigate its point prevalence and variations in BPD care.

Setting, patients and interventions: A multicentre cross-sectional study was conducted in 37 NICUs. 'Snapshot' clinical data on 18 June 2021 for individual patients born at <32 weeks gestation age (GA) were collected. BPD was defined based on the National Institute of Child Health and Human Development (NICHD) 2001 criteria and two newer criteria (NICHD 2018 and Jensen 2019).

Results: A total of 1044 infants born at <32 weeks GA were included, of which 72% were born at ≥28 weeks GA and 95.8% were born at ≥750 g. At the time of 'snapshot', 563 were ≥28 days old and 281 were ≥36 weeks postmenstrual age (PMA). The prevalence of BPD was 78.2% per NICHD 2001 definition. Infants with BPD were more likely to be born earlier with a lower birth weight and to have complications. Among infants who reached 36 weeks PMA, the point prevalence and severity of BPD differed across BPD definitions. Respiratory support and treatments for BPD also significantly varied.

Conclusion: Point prevalence of BPD is remarkably high in China. The prevalence of BPD was lowest according to the NICHD 2018 definition, whereas the NICHD 2001 definition classified most patients with severe BPD. We found infants with BPD have more complications and significant differences in BPD treatments between centres. Efforts to prevent BPD and standardise care are warranted in China.

Keywords: epidemiology; infant; neonatology.

Figure 1. Flow chart of BPD diagnosis. BPD, bronchopulmonary dysplasia; CXR, chest X-ray; FIO₂, fraction of inspired oxygen; GA, gestation age; NICHD, National Institute of Child Health and Human Development; PAM, postmenstrual age.