Changes in Neonatal Practice and Temporal Trends in Bronchopulmonary Dysplasia
Georgina Dickenson1, Oishi Sikdar2, Ravindra Bhatt2
1King's College London, London, United Kingdom.
American Journal of Perinatology
|July 30, 2025
Summary
Bronchopulmonary dysplasia (BPD) increased between 2012-2014 and 2020-2022, linked to more premature and growth-restricted infants. Increased use of hydrocortisone and diuretics did not improve outcomes.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Perinatal Research
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in neonatal intensive care, with increasing incidence.
- Understanding temporal trends in BPD is crucial for evaluating evolving neonatal care practices.
Purpose of the Study:
- To investigate the association between changes in neonatal care practices and temporal trends in BPD incidence.
- To compare BPD outcomes in infants born at <32 weeks gestation across two distinct time periods: 2012-2014 and 2020-2022.
Main Methods:
- Retrospective cohort study comparing infants born at <32 weeks gestation in two epochs (2012-2014 and 2020-2022).
- Data extracted from patient records and the BadgerNet electronic system.
- Outcomes stratified by gestational age (<28 weeks and 28-32 weeks).
Main Results:
- The recent epoch (2020-2022) included more immature infants (lower gestational age, higher proportion of small for gestational age).
- Moderate/severe BPD incidence increased significantly (64% vs. 39%, p<0.001) in the recent epoch.
- Increased use of hydrocortisone, diuretics, paracetamol, and less invasive surfactant administration was observed in the recent epoch, without improved outcomes or later discharge.
Conclusions:
- The rising incidence of BPD is associated with an increase in prematurity and growth restriction.
- Expanded use of hydrocortisone and diuretics in neonatal care was not linked to better BPD outcomes.
- Further research is needed to identify effective strategies for mitigating BPD in vulnerable neonates.
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