Bronchopulmonary dysplasia frequency and risk factors in very low birth weight infants: A 3-year retrospective study
Turgay Cokyaman1, Sultan Kavuncuoglu1
1Department of Pediatrics, Istanbul Bakirkoy Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
Insights
Bronchopulmonary dysplasia in premature infants is linked to respiratory distress syndrome, patent ductus arteriosus, apnea, late sepsis, early membrane rupture, and male gender. These factors show a significant, non-linear risk relationship, distinct from typical low birth weight and gestational age considerations.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Perinatal Epidemiology
Background:
- Bronchopulmonary dysplasia (BPD) is a significant comorbidity in very low birth weight (VLBW) infants.
- Identifying perinatal risk factors and comorbidities associated with BPD is crucial for improving outcomes.
Purpose of the Study:
- To evaluate the relationship between the frequency of bronchopulmonary dysplasia and various perinatal risk factors and comorbidities in VLBW infants.
Main Methods:
- Retrospective review of 872 VLBW infant files.
- Binary logistic regression analysis to assess the impact of clinical parameters on BPD frequency.
Main Results:
- The overall mortality rate was 20.9%, with a BPD frequency of 20.1% after 28-day mortality reduction.
- Significant risk factors for BPD included respiratory distress syndrome (OR 6.2), patent ductus arteriosus (OR 4.9), apnea (OR 4.1), late sepsis (OR 2.7), early membrane rupture (OR 2.6), and male gender (OR 1.6).
- Chorioamnionitis, antenatal steroids, small for gestational age, early sepsis, and birth type did not significantly affect BPD development.
Conclusions:
- BPD risk is significantly associated with respiratory distress syndrome, patent ductus arteriosus, late sepsis, apnea, early membrane rupture, and male gender.
- These associations demonstrate a non-linear risk relationship, differing from traditional low birth weight and gestational age correlations.
Objective:
In this study, the relationship between the frequency of bronchopulmonary dysplasia, perinatal risk factors and other prematurity comorbidities were evaluated in very low birth weight infants.
Methods:
A total of 872 very low birth weight infants' files were retrospectively reviewed. The effects of the clinical parameters, such as type of birth, small for gestational age, gender, antenatal steroids, early membrane rupture, chorioamnionitis, surfactant administration, respiratory distress syndrome, patent ductus arteriosus, apnea, early and late sepsis on the frequency of bronchopulmonary dysplasia, were evaluated by binary logistic regression analysis.
Results:
The overall mortality rate was 20.9%. After the first 28-day mortality reduction, the total bronchopulmonary dysplasia frequency was found to be 20.1%. The odds ratio and 95% confidence intervals of the factors affecting the development of bronchopulmonary dysplasia were found to be as follows respectively: respiratory distress syndrome (OR 6.2, 95% CI 3.6-10.6, p<0.01), patent ductus arteriosus (OR 4.9, 95% Cl 2.4-9.9, p<0.01), apnea (OR 4.1, 95% CI 2.5-6.9, p<0.01), late sepsis (OR 2.7, 95% CI 1.6-4.5, p<0.01), early membrane rupture (OR 2.6, 95% Cl 1.2-5.5, p=0.01), and male gender (OR 1.6, 95% CI 1.0-2.7, p=0.04) was found. However, there was no effect of chorioamnionitis, antenatal steroids, small for gestational age, early sepsis and type of birth on bronchopulmonary dysplasia.
Conclusion:
Differently from the usual factors which are low birth weight and a gestational week, there was a significant but non-linear risk relationship between respiratory distress syndrome, patent ductus arteriosus, late sepsis, apnea, early membrane rupture, male gender and bronchopulmonary dysplasia.
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