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Increased bronchopulmonary dysplasia along with decreased mortality in extremely preterm infants

Ga Won Jeon1, Minkyung Oh2, Yun Sil Chang3,4

  • 1Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.

Scientific Reports
|March 14, 2025
PubMed

Insights

Despite advances in neonatal care, extremely preterm infants (EPIs) face increasing rates of bronchopulmonary dysplasia (BPD). This trend suggests a trade-off between survival and BPD incidence in EPIs, driven by longer ventilatory support.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Neonatal intensive care has improved survival for extremely preterm infants (EPIs).
  • However, bronchopulmonary dysplasia (BPD) incidence remains high or is increasing in this population.
  • Understanding trends in BPD and mortality is crucial for optimizing care for EPIs.

Purpose of the Study:

  • To examine trends in mortality, BPD, and the composite outcome of BPD or mortality among EPIs in Korea.
  • To investigate the relationship between ventilatory support strategies and these outcomes.

Main Methods:

  • Analysis of a nationwide cohort of EPIs (gestational age 23-27 weeks) from the Korean Neonatal Network (2014-2021).
  • Inclusion of 4,450 survivors for outcome assessment.
  • Comparison of BPD incidence, mortality rates, and composite outcomes over the study period.

Main Results:

  • BPD incidence in survivors increased from 51.2% to 62.7% (P < 0.001).
  • Mortality declined significantly from 28.3% to 19.5% (P < 0.001).
  • The composite outcome of BPD or mortality increased from 63.6% to 66.9% (P = 0.006), associated with increased duration of overall ventilatory support.

Conclusions:

  • Despite reduced mortality, the incidence of BPD and the composite outcome of BPD or mortality have increased among EPIs in Korea.
  • Prolonged ventilatory support, particularly non-invasive ventilation, may contribute to the rising BPD rates.
  • There appears to be a trade-off between improved survival and increased BPD incidence in extremely preterm infants.

Keywords:
Bronchopulmonary dysplasiaExtremely preterm infantMorbidityNeonatal intensive careSurvival rate

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