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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs

Published on: October 31, 2025

Prevention of bronchopulmonary dysplasia

Matthew M Laughon1, P Brian Smith, Carl Bose

  • 1UNC Hospitals, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. matt_laughon@med.unc.edu

Seminars in Fetal & Neonatal Medicine
|September 9, 2009
PubMed

Insights

Preventing bronchopulmonary dysplasia (BPD) in premature infants remains challenging. While vitamin A, corticosteroids, caffeine, and phototherapy show modest benefits, new strategies with proven efficacy are needed.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Critical Care

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in premature infants.
  • Despite extensive research, most strategies to prevent BPD have proven unsuccessful.

Purpose of the Study:

  • To review the evidence for therapies aimed at reducing the incidence of BPD.
  • To identify effective BPD prevention strategies and highlight the need for further research.

Main Methods:

  • Review of randomized controlled trials (RCTs) and cohort studies.
  • Analysis of existing literature on BPD prevention therapies.

Main Results:

  • Parenteral vitamin A and corticosteroids are the only BPD-specific preventive treatments with RCT-supported efficacy.
  • Caffeine for apnea of prematurity and aggressive phototherapy for hyperbilirubinemia also reduce BPD incidence.
  • Continuous positive airway pressure (CPAP) may reduce BPD by avoiding mechanical ventilation, supported by cohort studies.
  • Many other therapies show promise in animal models but lack human efficacy for BPD prevention.
  • Efficacious therapies provide modest benefits, with absolute risk reductions of 7-11%.

Conclusions:

  • Current effective BPD prevention strategies offer limited benefits.
  • Further research and rigorous testing in RCTs are essential for developing new, effective BPD preventive strategies.
  • Modest reductions in BPD incidence should be the expectation for novel therapies.

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