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Bronchopulmonary dysplasia in very low birthweight infants
Insights
Bronchopulmonary dysplasia (BPD) affected 6% of very low birthweight infants, with higher incidence in those under 1000g. Associated factors included perinatal asphyxia and respiratory distress, impacting long-term costs.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Perinatal Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in premature infants.
- Very low birthweight infants are at high risk for respiratory morbidities.
Purpose of the Study:
- To determine the incidence of BPD in very low birthweight infants.
- To identify risk factors and clinical characteristics associated with BPD.
Main Methods:
- Retrospective analysis of 375 infants with birthweights <= 1500g.
- Comparison of infants with and without BPD, analyzing perinatal factors and treatment durations.
Main Results:
- BPD incidence was 6% overall, higher (15%) in infants <1000g.
- Perinatal asphyxia, respiratory distress, pulmonary interstitial emphysema, and PDA were more common in BPD infants.
- Mean oxygen therapy was 68 days, ventilatory therapy 37 days.
Conclusions:
- BPD is a considerable concern in very low birthweight populations.
- While certain perinatal factors are associated, none predicted mortality from BPD.
- Prolonged treatment for BPD has significant psychosocial and economic implications.
Abstract:
Twenty-four (6%) of 375 infants with birthweights less than or equal to 1500g developed bronchopulmonary dysplasia (BPD); 16 (15%) of 107 in those less than or equal to 100g and 8 (3%) of 268 in those greater than 1000g. The incidence was 10% in those who required assisted ventilation. Perinatal asphyxia, significant respiratory distress, pulmonary interstitial emphysema and patent ductus arteriosus were statistically more common in BPD infants compared with the remaining 351 very low birthweight infants. Hyaline membrane disease was the primary respiratory disease in 54% of BPD infants. The mean durations of oxygen and ventilatory therapy were 68 days and 37 days respectively. Twenty-nine percent did not require more than 60% oxygen for over 24 hours. Only 38% required a peak airway pressure of over 30 cmH2O. Early postnatal growth was satisfactory on parenteral nutrition support. No perinatal factor was found to be predictive of death from BPD. The prolonged duration of hospital treatment has obvious implications to the psychosocial and economic costs of BPD.