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[Incidence and mortality of bronchopulmonary dysplasia]
J Figueras Aloy1, J Molina González, J M Vilanova Juanola
1Servicio de Neonatología. Subdivisión de Pediatría, Hospital Clínico y Facultad de Medicina, Barcelona.
Insights
Bronchopulmonary dysplasia (BPD) incidence remained stable, but mortality significantly decreased in premature infants between 1979-1989. This analysis highlights key risk factors including low birth weight and prematurity for BPD development.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Clinical Epidemiology
Context:
- Bronchopulmonary dysplasia (BPD) is a significant complication in premature infants requiring respiratory support.
- Understanding BPD incidence and severity variations is crucial for improving neonatal care outcomes.
- This study reviews clinical records from 1979-1989 to analyze BPD trends in a specific environment.
Purpose:
- To analyze the variations in incidence and severity of bronchopulmonary dysplasia (BPD) in premature infants.
- To identify epidemiological factors associated with BPD development and mortality.
- To assess changes in BPD rates and outcomes over a decade.
Summary:
- BPD diagnosis required assisted ventilation for ≥72 hours, compatible chest radiography, and FiO2 >0.21 on day 28.
- Between 1985-1989, BPD incidence (38.3%) was similar to 1979-1984 (42.3%), but mortality decreased from 36.3% to 21.7%.
- High-risk groups included infants <1000g (73%), <28 weeks gestation (100%), and those with hyaline membrane disease (30.7%).
Impact:
- The findings indicate a positive trend in BPD mortality reduction despite stable incidence.
- Identifies critical risk factors such as extremely low birth weight and very early gestational age.
- Provides valuable epidemiological data for targeted interventions and improved management strategies for BPD in neonates.
Abstract:
In this paper an attempt is made to analyze the variations in the incidence and severity of bronchopulmonary dysplasia (BPD) in our environment. A review has been made of the clinical records of premature infants with a diagnosis of BPD from 1979 to 1989, both inclusive. The existence of BPD was accepted when, after assisted ventilation with intermittent positive pressure for a minimum of 72 hours, there were respiratory difficulties, a compatible radiography of the thorax and requirements of over 0.21 FiO2 on the 28th day of life. Between 1985 and 1989, the incidence of BPD was similar to that of the five previous years (38.3% versus 42.3%), but mortality decreased (21.7% versus 36.3%). Other epidemiological data worth noting are the appearance of BPD in 2.6 per 1000 live newborns, 9.6 per 1000 newborns kept in hospital and 15.9% of premature infants treated with ventilation. BPD was found in 73% of newborns weighing less than 1.000 g, 41% weighing between 1000 and 1.499 g and only 16% of those weighing over 1,499 g. BPD was found in all newborns of less than 28 weeks, in 38% of those between 28 and 30 weeks and only in 4% of those aged more than 30 weeks. BPD appeared specially after hyalline membrane disease (30.7%).