Risk Factors Contributing to the Development of Bronchopulmonary Dysplasia

Despite advances in medical care, the incidence and severity of bronchopulmonary dysplasia (BPD) among infants born at less than 32 weeks' gestation have not decreased. Also, BPD prediction tools have been criticized for containing too few variables, not being validated beyond their initial development, and having a lack of generalizability. To develop a comprehensive prediction tool for postnatal use, a broad evaluation of BPD risk factors is needed.

To examine risk factors for the development of BPD among a sample of preterm infants.

This research was a retrospective cohort study examining preterm infants (n = 455) treated at a level IV neonatal intensive care unit. Binary logistic regression was used to examine the relationship between BPD and 15 risk factors that were identified through a comprehensive review of the literature. Multinomial regression was used to examine the relationship between risk factors and the severity of BPD.

Risk factors for BPD that were identified included birth weight, surfactant administration, and mechanical ventilation. When examined by severity, other risk factors identified were gestational age, infections, and the presence of a patent ductus arteriosus.

The variables most frequently included in contemporary BPD prediction tools include gestational age, birth weight, sex, and early respiratory status. The findings of this research demonstrate that the addition of multiple surfactant doses, infections, and patent ductus arteriosus as BPD risk factors might strengthen BPD prediction tools. Moreover, a number of blood transfusions and weights deserve further evaluation in future research as potential BPD risk factors.