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New BPD-prevalence and risk factors for bronchopulmonary dysplasia/mortality in extremely low gestational age infants

Odattil Geetha1,2,3,4, Victor Samuel Rajadurai5,6,7,8, Amudha Jayanthi Anand5,6,7,8

  • 1Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore. odattil.geetha@singhealth.com.sg.

Journal of Perinatology : Official Journal of the California Perinatal Association
|May 25, 2021
PubMed

Insights

The prevalence of moderate-severe Bronchopulmonary dysplasia (BPD) or death in extremely low gestation age neonates (ELGANs) decreases with increasing gestational age. Mechanical ventilation by Day 7 is an independent predictor of this composite outcome.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Perinatology

Background:

  • Bronchopulmonary dysplasia (BPD) remains a significant challenge in extremely low gestation age neonates (ELGANs).
  • Understanding the prevalence and risk factors for BPD/death is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To evaluate the prevalence and identify risk factors associated with moderate-severe Bronchopulmonary dysplasia (BPD) or death in extremely low gestation age neonates (ELGANs).

Main Methods:

  • A cohort of 266 ELGANs born at gestational age (GA) ≤ 28 weeks was studied.
  • The primary outcome measure was a composite of moderate-severe BPD or death, defined by NICHD (2001) criteria.
  • Statistical analysis included univariate and independent predictive modeling.

Main Results:

  • The overall mortality rate was 19%, and moderate-severe BPD occurred in 67% of ELGANs.
  • Prevalence of BPD/death decreased significantly with increasing GA, from 86-93% at 23-24 weeks to <60% at 27-28 weeks.
  • Need for mechanical ventilation on Day 7 was the only independent predictor of the composite outcome (OR 1.97; 95% CI; 1.3-3.1).

Conclusions:

  • Gestational age is a key determinant of BPD/death risk in ELGANs.
  • Identifying risk factors like the need for early mechanical ventilation can inform targeted interventions.
  • Further research can develop predictive models and lung-protective strategies for ELGANs.
Abstract

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