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Occurrence, predictive factors and associated morbidity of bronchopulmonary dysplasia in a preterm birth cohort
A Hakulinen1, K Heinonen, V Jokela
1Children's Hospital, Kuopio, Finland.
Insights
Bronchopulmonary dysplasia (BPD) significantly impacts preterm infants born before 32 weeks, leading to increased morbidity and prolonged hospitalizations. Early respiratory distress syndrome (RDS) is a key factor, highlighting the need for targeted interventions.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Perinatal Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Understanding BPD's incidence, predictors, and long-term morbidity is crucial for improving outcomes.
Purpose of the Study:
- To examine the occurrence, predictive factors, and associated morbidity of BPD in a preterm birth cohort.
- To identify factors that predict the development of BPD in early life.
Main Methods:
- Retrospective cohort study of 712 preterm infants born before 37 weeks gestation (1978-1982).
- Analysis of BPD occurrence, neonatal morbidity, and long-term health status up to two years.
Main Results:
- BPD incidence was 135 per 1000 live preterms born at or before 32 weeks.
- Most BPD cases followed respiratory distress syndrome (RDS); few predictive factors were identified.
- BPD survivors experienced significantly higher rates of respiratory infections, neurologic sequelae, and retrolental fibroplasia.
Conclusions:
- BPD poses a substantial burden on preterm infants, extending beyond the neonatal period.
- Early RDS and prematurity are critical risk factors for BPD development.
- BPD survivors require significant healthcare resources due to long-term complications.
Abstract:
The occurrence, predictive factors and associated morbidity of bronchopulmonary dysplasia (BPD) was examined in a preterm birth cohort of 712 children, born before 37 weeks of gestation to residents of a geographically defined area between 1978-82. All cases of BPD (N = 16) were born at or before 32 weeks of gestation. The incidence of BPD, based on status at the age of 28 days, was 1 per 1000 live births, but 135 per 1000 live preterms born at or before 32 weeks. Most cases of BPD developed following respiratory distress syndrome (RDS), only one case developing after minimal respiratory symptoms was observed. BPD infants had higher neonatal morbidity, even when compared with preterms of equal gestational maturity, but only a few variables had predictive value with respect to the future development of BPD. Radiologic grading of RDS and associated early cardiologic signs did not increase their predictivity regarding the subsequent development of BPD. Two (12.5%) of the 16 BPD infants died postneonatally. The unfavorable effects of BPD on the health status of preterm infants extended far beyond the neonatal period. The BPD group, which consisted only of 18% of neonatal survivors born at less than or equal to 32 weeks, consumed 53% of all hospital days used by these preterms during the first two years of life. In particular, BPD survivors had markedly more respiratory infections (63%), more neurologic sequelae (37%) and more cases of retrolental fibroplasia (12%) than their non-BPD counterparts.