Prevalence and Risk Factors of Bronchopulmonary Dysplasia Among Very Premature Infants in a Tunisian Neonatal
Mouadh Benali1, Nourzed Ben Hamida1, Salsabil Jaouhari1
1University of Tunis ElManar, Faculty of Medicine of Tunis, 1068, Charles Nicolle University Hospital, Service of Neonatology, 1006, Tunis, Tunisia.
Insights
Bronchopulmonary dysplasia (BPD) affects over a third of very preterm infants, with maternal hypertensive disorders, chorioamnionitis, IUGR, early gestation, and mechanical ventilation being key risk factors. This condition significantly increases mortality risk in premature infants.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Perinatal Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is the leading chronic respiratory disease in premature infants.
- Its increasing prevalence, mortality, and socioeconomic impact highlight a significant public health concern.
- Understanding BPD's risk factors is crucial for improving outcomes in vulnerable neonates.
Purpose of the Study:
- To determine the prevalence of BPD in very preterm infants.
- To identify independent risk factors associated with BPD development.
- To analyze the impact of BPD on mortality rates in this population.
Main Methods:
- Retrospective, descriptive, and analytical study of premature infants (26-31 weeks gestation) surviving beyond 28 days.
- Data collected over a five-year period (2017-2021).
- BPD defined as need for oxygen supplementation for at least 28 days; multivariate analysis used to identify risk factors.
Main Results:
- BPD prevalence was 37.7% at 28 days and 36.7% at 36 weeks postmenstrual age.
- Independent risk factors included maternal hypertensive disorders, chorioamnionitis, intrauterine growth restriction (IUGR), gestational age < 30 weeks, and mechanical ventilation (MV).
- Mortality rate was significantly higher in infants with BPD (10.3%) compared to those without (0.7%).
Conclusions:
- A high prevalence of BPD exists in very preterm infants.
- Maternal hypertensive disorders, IUGR, chorioamnionitis, MV, and early gestational age (<30 weeks) are significant independent risk factors for BPD.
- BPD is associated with a substantially increased risk of mortality in very preterm infants.
Introduction:
Bronchopulmonary dysplasia (BPD) stands as the primary chronic respiratory complication in premature infants, posing a substantial public health concern due to its rising prevalence, potential mortality, and socioeconomic burden.
Aim:
The aim of this study was to determine the prevalence of BPD in very preterm infants and identify its associated risk factors.
Methods:
We conducted a retrospective, descriptive, and analytical study including all premature infants born between 26 and 31 weeks of gestation age (GA) who survived beyond the 28th day of life, over a five-year period (2017-2021). Patients were divided into two groups based on the presence or absence of BPD, which was defined by the need for oxygen supplementation for at least 28 days.
Results:
we included 231 newborns. The prevalence of BPD was 37.7% among survivors on the 28th day of life and 36.7% among those reaching 36 weeks postmenstrual age. BPD was mild, moderate and severe in 25.2%, 4.9% and 6.6% of cases, respectively. Multivariate analysis identified maternal hypertensive disorders (RR=6.15, 95%CI=[2.27-16.67], p<0.001), chorioamnionitis (RR=4.23, 95%CI=[1.25 -14.27], p=0.02), intrauterine growth restriction (IUGR) (RR =20.4, 95%CI=[3.39 -122.66], p=0.001), GA less than 30 weeks (RR=26.97, 95%CI=[10.23 -71.14], p<0.001), and mechanical ventilation (MV) (RR=5.33, 95%CI=[1.95-14.54], p=0.001) as independent factors associated with BPD occurrence. The mortality rate was 10.3% among patients with BPD versus 0.7% in patients without BPD (p = 0.001).
Conclusion:
Our study revealed a high prevalence of BPD in very preterm infants and identified several independent risk factors such as maternal hypertensive disorders, IUGR, chorioamnionitis, MV, and GA less than 30 weeks.
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