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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center,

Yan-Ping Xu1, Zheng Chen1, Robert M Dorazio2

  • 1NICU, Children's Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, 310052, China.

Scientific Reports
|October 19, 2023
PubMed

Insights

Post-natal inflammation significantly increases the risk of severe Bronchopulmonary dysplasia (BPD) in preterm infants. Key risk factors include late-onset sepsis, ventilator-associated pneumonia, and necrotizing enterocolitis.

Area of Science:

  • Neonatology
  • Pediatric critical care
  • Respiratory medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a common complication of prematurity, influenced by both pre- and post-natal factors.
  • Identifying modifiable risk factors is crucial for improving outcomes in preterm infants.

Purpose of the Study:

  • To investigate the association between inflammation-related factors and the risk of developing BPD in preterm infants.
  • To identify specific post-natal risk factors contributing to severe BPD.

Main Methods:

  • A prospective, longitudinal cohort study involving 1088 preterm infants (gestational age < 32 weeks) from 25 hospitals in China.
  • Infants were assessed for BPD and its severity at 36 weeks post-menstrual age.
  • Statistical analysis, including logistic regression, was used to identify risk factors.

Main Results:

  • Six factors were significantly associated with severe BPD: lower birth weight, surfactant treatment, high mean airway pressure (MAP ≥ 12 cm H2O), late-onset sepsis (LOS), ventilator-associated pneumonia (VAP), and necrotizing enterocolitis (NEC).
  • Post-natal inflammation-related factors like LOS, VAP, and NEC showed a strong association with increased BPD severity.
  • Ventilator-associated pneumonia (VAP) had the highest odds ratio (18.236) for severe BPD.

Conclusions:

  • Post-natal inflammation-related factors are significantly associated with an increased risk of severe BPD in preterm infants.
  • Targeting and mitigating post-natal inflammatory complications may be key to reducing BPD severity.
  • Regional variations in BPD risk highlight the need for localized prevention strategies.

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