Comparison of New Bronchopulmonary Dysplasia Definitions on Long-Term Outcomes in Preterm Infants

Area of Science:

• Neonatology
• Pediatric Pulmonology
• Developmental Pediatrics

Background:

• Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
• Current diagnostic criteria for BPD include the 2001 NIH definition, the 2018 NIH definition, and the 2019 Jensen definition.
• These definitions vary in their criteria and may impact long-term outcome prediction.

Purpose of the Study:

• To compare the discriminative performance of the 2018 NIH and 2019 Jensen definitions of BPD against the 2001 NIH definition.
• To evaluate the predictive accuracy of these BPD definitions for adverse neurodevelopmental and respiratory outcomes at 2 and 5 years corrected age.

Main Methods:

• A single-center retrospective cohort study included 584 infants born before 30 weeks of gestational age.
• BPD presence and severity were assessed using the 2001 NIH, 2018 NIH, and 2019 Jensen definitions.
• The discriminative power for neurodevelopmental impairment (NDI) or death and respiratory morbidity was compared using receiver operating characteristic (ROC) curves and z-statistics.

Main Results:

• There were notable differences in BPD grading across the three definitions.
• All BPD definitions demonstrated comparable discriminative power for NDI and respiratory morbidity at 2 and 5 years corrected age.
• The 2018 NIH definition showed slightly less predictive power for neurologic outcomes at 2 years corrected age compared to the 2001 NIH definition.

Conclusions:

• The 2018 NIH and 2019 Jensen definitions of BPD exhibit similar discriminative performance for long-term neurodevelopmental and respiratory outcomes as the 2001 NIH definition.
• These findings suggest that current BPD definitions are broadly comparable in predicting key infant outcomes at 2 and 5 years corrected age.