Related Experiment Video
Updated: Oct 3, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
The Consensus Definition of Bronchopulmonary Dysplasia Is an Adequate Predictor of Lung Function at Preschool Age
Segundo Rite1,2, Carlos Martín de Vicente3, Juan P García-Iñiguez3
1Division of Neonatology, Department of Pediatrics, Miguel Servet University Hospital, Zaragoza, Spain.
Insights
The 2001 definition of bronchopulmonary dysplasia (BPD) accurately predicts preschool lung function. Moderate-to-severe BPD is the strongest predictor of respiratory impairment in children.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Recent definitions of bronchopulmonary dysplasia (BPD) focus on early respiratory outcomes, removing the 28-day oxygen requirement.
- This study evaluates the 2001 BPD consensus definition's ability to predict later lung function.
- Assessing BPD definitions is crucial for understanding long-term respiratory health in preterm infants.
Purpose of the Study:
- To determine if the 2001 consensus definition of BPD can predict impaired lung function at preschool age (4-6 years).
- To identify risk factors associated with BPD development and its impact on lung function.
- To compare lung function across different BPD severity groups.
Main Methods:
- A cohort of children born before 32 weeks GA or weighing <1500g were assessed at 4-6 years old.
- Incentive spirometry was performed, and lung function parameters were compared to Global Lung Function Initiative (GLI-2012) reference values.
- Univariate, multivariate, and subgroup analyses were conducted to identify risk factors and compare lung function between no BPD, mild BPD, and moderate-to-severe BPD groups.
Main Results:
- Gestational age, patent ductus arteriosus, and late sepsis were independent risk factors for BPD.
- All participants showed altered lung function compared to reference values.
- Moderate-to-severe BPD was independently associated with significant impairment in forced expiratory volume in the first 0.75 seconds (FEV0.75) and forced vital capacity (FVC), while mild BPD showed FEV0.75 reduction.
Conclusions:
- The 2001 BPD definition demonstrates adequate predictive capacity for preschool lung function.
- Moderate-to-severe BPD is the most significant predictor of impaired respiratory outcomes.
- Even mild BPD is associated with measurable changes in lung function, specifically FEV0.75.
Background:
Recent attempts to refine the definition bronchopulmonary dysplasia (BPD) have based its predictive capacity on respiratory outcome in the first 2 years of life, eliminating the pre-existing requirement of 28 days of oxygen therapy prior to 36 weeks postmenstrual age (PMA). The objective of this study was to assess the utility of the 2001 consensus definition in predicting impaired lung function at preschool age.
Methods:
This cohort study included children aged 4-6 years old who were born at gestational age (GA) <32 weeks or bodyweight <1500 g. Univariate and multivariate analyses were performed to assess differences in antenatal and neonatal variables between BPD and non-BPD children. All participants underwent incentive spirometry. Lung function parameters were contrasted with the Global Lung Function Initiative (GLI-2012) reference equations and, together with antenatal and neonatal variables, compared among the different subgroups (no BPD, mild BPD, and moderate-to-severe BPD). A multivariate model was generated to identify independent risk factors for impaired lung function.
Results:
GA, hemodynamically significant patent ductus arteriosus, and late sepsis were independent risk factors for the development of BPD. A total of 119 children underwent incentive spirometry. All lung function parameters were significantly altered relative to reference values. Greater impairment of lung function was observed in the mild BPD vs. the no BPD group (forced expiratory volume in the first 0.75 seconds [FEV0.75]: -1.18 ± 0.80 vs. -0.55 ± 1.13; p = 0.010), but no difference in forced vital capacity (FVC) was observed (-0.32 ± 0.90 vs. -0.18 ± 1; p = 0.534). The moderate-to-severe BPD group exhibited the most severe FEV0.75 reduction (FEV0.75: -2.63 ± 1.18 vs. -0.72 ± 1.08; p = 0.000) and was the only condition with FVC impairment (FVC: -1.82 ± 1.12 vs. -0.22 ± 0.87; p = 0.000). The multivariate analysis identified a diagnosis of moderate-to-severe BPD as an independent risk factor for lung function impairment.
Conclusion:
The 2001 consensus definition of BPD has adequate predictive capacity for lung function measured by spirometry at 4-6 years of age. Moderate-to-severe BPD was the best predictor of respiratory impairment. Children with mild BPD showed greater alteration of FEV0.75 than those without BPD.
Related Concept Videos
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:25Pulmonary Function Tests
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
01:17Pulmonary Cycle: Exhalation
01:26COPD: Management Using Bronchodilators and Corticosteroids