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Bronchopulmonary Dysplasia in Early Infancy: A Nationwide Population-Based Study of Prevalence and Care Utilization
Andrea Parra Buitrago1, Ranniery Acuña-Cordero2, Jefferson Antonio Buendía3
1Departamento de Neumología Pediátrica, Hospital Pablo Tobón Uribe, Facultad de Medicina, Universidad Pontificia Bolivariana Medellín, Medellín, Colombia.
Insights
Bronchopulmonary dysplasia (BPD) affects many infants in Colombia, with higher rates in males and those with contributive insurance. Administrative data proves valuable for tracking this evolving lung disease burden.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in premature infants.
- Epidemiological data on BPD in low- and middle-income countries are limited, hindering effective health system planning.
- Existing studies often focus on neonatal intensive care unit cohorts, limiting generalizability.
Purpose of the Study:
- To estimate the prevalence and characterize temporal trends of BPD in Colombian infants under one year (2015-2024).
- To identify sex-specific differences, health insurance disparities, and healthcare utilization patterns for BPD.
- To assess the utility of administrative healthcare data for BPD surveillance.
Main Methods:
- Nationwide retrospective population-based study using administrative healthcare data (RIPS) and population projections (DANE).
- BPD cases identified via ICD-10 code P27.1; prevalence calculated per 100,000 infants.
- Age-standardization using WHO standard population; temporal trends analyzed with LOESS and segmented regression.
Main Results:
- Crude BPD prevalence was 149.0 per 100,000 infants, with similar age-standardized rates.
- Prevalence was higher in males and infants with contributive health insurance.
- Non-linear temporal trends observed, peaking around 2019-2020; increased pulmonology visits but limited advanced diagnostics.
Conclusions:
- BPD poses a significant and dynamic population-level health burden in Colombia.
- Administrative healthcare data provide a scalable method for BPD surveillance and health system planning in resource-limited settings.
- The findings underscore the need for targeted interventions and improved data collection for BPD management.
Background:
Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease of prematurity; however, population-based epidemiological data from low- and middle-income countries remain scarce. Most available evidence is derived from neonatal intensive care unit cohorts, limiting generalizability and constraining health system planning. We aimed to estimate the crude and age-standardized prevalence of BPD among infants younger than 1 year in Colombia between 2015 and 2024, and to characterize temporal trends, sex-specific differences, health insurance-related disparities, and patterns of healthcare utilization.
Methods:
We conducted a nationwide retrospective population-based study using administrative healthcare data from the Colombian Registro Individual de Prestación de Servicios de Salud (RIPS), linked to population projections from the National Administrative Department of Statistics (DANE). BPD cases were identified using the ICD-10 code P27.1. Prevalence rates per 100,000 infants were calculated with exact 95% confidence intervals and age-standardized using the World Health Organization standard population. Temporal trends were assessed using LOESS smoothing and segmented regression. Adjusted prevalence ratios were estimated using Poisson regression models with population offsets.
Results:
Between 2015 and 2024, the crude prevalence of BPD was 149.0 per 100,000 infants (95% CI: 146.1-152.0), with similar age-standardized estimates. Prevalence was consistently higher in males and among infants affiliated with the contributive insurance regime. Temporal trends exhibited a non-linear pattern, with a peak around 2019-2020. Pediatric pulmonology follow-up visits increased substantially over time, whereas the use of advanced diagnostic testing remained limited.
Conclusions:
BPD represents a substantial and evolving population-level burden in Colombia. Routinely collected administrative healthcare data offer a scalable and pragmatic approach for disease surveillance and health system planning in settings lacking national neonatal registries.
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