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Bronchopulmonary dysplasia: definitions and long-term respiratory outcome

Eugenio Baraldi1, Silvia Carraro, Marco Filippone

  • 1Unit of Respiratory Medicine and Allergy, Department of Pediatrics, University of Padova, Via Giustiniani 3, 35128 Padova, Italy. baraldi@pediatria.unipd.it

Early Human Development
|October 2, 2009
PubMed

Insights

Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants. Recent definitions highlight BPD as a developmental disorder with long-term respiratory issues like airflow obstruction.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant sequela of premature birth, resulting from perinatal/neonatal lung injury.
  • It is a leading cause of chronic respiratory morbidity in survivors of preterm birth.

Purpose of the Study:

  • To discuss recent changes in the definition of Bronchopulmonary dysplasia (BPD).
  • To compare the old and new classifications of BPD.
  • To summarize current data on the long-term respiratory outcomes for BPD patients.

Main Methods:

  • Review of recent literature on BPD definitions and outcomes.
  • Analysis of longitudinal studies assessing respiratory function in BPD survivors.
  • Comparison of diagnostic criteria and severity grading between old and new BPD classifications.

Main Results:

  • The current definition of BPD relies on the need for supplemental oxygen for at least 28 days post-birth.
  • Severity is graded by respiratory support needs at 36 postmenstrual weeks.
  • The "new BPD" is characterized as a developmental disorder impacting lung structural complexity, associated with increased need for asthma medications and airflow obstruction in longitudinal studies.

Conclusions:

  • The "new BPD" represents a failure of the immature lung to achieve full structural complexity.
  • Long-term respiratory sequelae include significant airflow obstruction and increased use of inhaled asthma medications.
  • Further long-term lung function studies are needed to determine if BPD survivors are at risk for developing a COPD-like phenotype in aging.

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