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Determinants of chronic lung disease severity in the first year of life; A population based study

Susan Gage1, Peiyi Kan1, John Oehlert1

  • 1Stanford University Department of Pediatrics, California Perinatal Quality Care Collaborative(CPQCC), California High Risk Infant Follow up (HRIF), Stanford, California.

Pediatric Pulmonology
|February 6, 2015
PubMed

Insights

A new clinical severity score for chronic lung disease of infancy (CLDi) was developed. Male infants, longer ventilation, and postnatal steroids increased CLDi severity, while severe retinopathy of prematurity decreased it.

Area of Science:

  • Neonatology and Pediatric Pulmonology
  • Infant Lung Health and Morbidity Assessment

Background:

  • Chronic lung disease of infancy (CLDi) is a significant concern for premature infants following neonatal intensive care unit (NICU) stays.
  • Standardized methods for assessing CLDi severity and identifying associated risk factors are crucial for improving infant outcomes.

Purpose of the Study:

  • To develop a clinical severity score for infants with CLDi post-NICU.
  • To identify factors associated with CLDi clinical severity at 4-9 months corrected gestational age (CGA) using population-based data.

Main Methods:

  • Pediatric pulmonologists ranked and weighted factors contributing to CLDi clinical severity.
  • A CLDi clinical severity score was created and applied to infants born <30 weeks gestational age (GA) with moderate/severe bronchopulmonary dysplasia (BPD).
  • Data from the California High Risk Infant Follow up (HRIF) program and California Perinatal Quality Care Collaborative (CPQCC) were utilized.

Main Results:

  • Expert pulmonologists showed strong agreement on the ranking and weighting of CLDi severity parameters.
  • Data from 940 infants revealed that male sex, >30 ventilator days, and postnatal steroid use were associated with severe CLDi scores.
  • An inverse association was observed between severe CLDi scores and stage 3-4 retinopathy of prematurity.

Conclusions:

  • The developed CLDi clinical severity score enables standardized assessment of pulmonary morbidity in infants post-NICU.
  • Identified risk factors, including male sex, prolonged ventilation, and postnatal steroid use, aid in evaluating CLDi outcomes.
  • The findings highlight key factors influencing CLDi severity at 4-9 months corrected gestational age.
Abstract

Keywords:
bronchopulmonary dysplasiachronic lung disease of infancypremature

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