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Risk factors and bronchopulmonary dysplasia severity: data from the Spanish Bronchopulmonary Dysplasia Research

Cristina Ramos-Navarro1, Elena Maderuelo-Rodríguez2, Ana Concheiro-Guisán3

  • 1Neonatologist at Neonatology Department, Gregorio Marañón University Hospital, O'Donnell 48 street, 28009, Madrid, Spain. cramosn@salud.madrid.org.

European Journal of Pediatrics
|October 1, 2021
PubMed

Insights

Mechanical ventilation duration is the primary risk factor for severe bronchopulmonary dysplasia (BPD) in preterm infants. Higher oxygen needs at 36 weeks postmenstrual age correlate with increased BPD morbidity.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Public Health

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease common in preterm infants.
  • BPD is a multifactorial condition influenced by various perinatal factors.
  • Understanding risk factors is crucial for improving BPD outcomes.

Purpose of the Study:

  • To analyze the characteristics of BPD patients.
  • To investigate the impact of perinatal risk factors on BPD severity.
  • To identify key predictors of BPD severity and associated morbidity.

Main Methods:

  • Observational study using the GEIDIS national registry of BPD patients in Spain.
  • Inclusion of 1755 preterm infants diagnosed with BPD.
  • Analysis of prenatal and postnatal risk factors, including mechanical ventilation duration and oxygen requirements.

Main Results:

  • The length of exposure to mechanical ventilation (MV) was the most significant risk factor for moderate to severe BPD (type 2/3).
  • Independent prenatal risk factors included male gender, oligohydramnios, and intrauterine growth restriction.
  • Postnatal factors like nosocomial pneumonia and high oxygen needs in the delivery room were also associated with BPD severity.

Conclusions:

  • Prolonged mechanical ventilation is the leading risk factor for severe BPD, modulating other risk factors.
  • Preterm infants with severe BPD requiring FiO2 > 0.30 at 36 weeks postmenstrual age experienced higher morbidity.
  • This study highlights the critical role of MV duration in BPD pathogenesis and outcomes.

Keywords:
Bronchopulmonary dysplasiaGEIDIS networkIntrauterine growth restrictionMechanical ventilationOligohydramniosPreterm infants

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