Occurrence, predictive factors and associated morbidity of broncho-pulmonary dysplasia in a preterm birth cohort

Hakulinen, A.; Heinonen, Kirsti; Jokela, Veikko; Kiekara, Olavi

doi:10.1515/jpme.1988.16.5-6.437

Cited by 25 publications

(17 citation statements)

References 20 publications

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“…Although developed for another outcome, these validation studies aimed to determine to which extent the prediction rule could predict BPD. Of the included reports, four studies developed a model using radiographic scoring, but also a prediction rule without this diagnostic tool and were therefore included [13,26,29,44]. Four study reports presented a prediction rule based on clinical information collected after the 7 th postnatal day which was beyond the scope of this review, but presented a prediction rule based on early postnatal information as well, which was included [14,30,34,40].…”

Section: Resultsmentioning

confidence: 99%

“…* Two models [12,13] did not include continuous estimators in their models, so handling of continuous predictor are calculated over 17 models.# Romagnoli [32] presented 3 models, of which one dichotomized birth weight and one score chart.† Ambalavanan [39] presented a CART model dichotomizing continuous predictor estimates in his manuscript, but provided us a model formula keeping the continuous outcomes linear.…”

Section: Resultsmentioning

confidence: 99%

“…* Two models [12,13] did not include continuous estimators in their models, so handling of continuous predictor are calculated over 17 models.…”

Section: Resultsmentioning

confidence: 99%

“…Six models could not be validated because variables on either fluid intake, weight loss after the first week of life, or exact duration of high oxygen and positive inspiratory pressure were not available in the PreVILIG dataset and no proxy variable could be imputed [12,13,28,35,38,47]. …”

Section: Resultsmentioning

confidence: 99%

“…However, these variables may be difficult to assess in daily clinical practice, jeopardizing their implementation in routine care. For instance, three of the untested models included the concentration of oxygen or positive inspiratory pressure for a prescribed time [12,13,28], or included weight loss, fluid intake or urine output as predictors [35,38,47]. These variables are not collected easily even in a prospective study and more importantly are not independent of local protocols or habits [12,28].…”

Section: Discussionmentioning

confidence: 99%

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Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study

et al. 2013

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BackgroundBronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Very different models using clinical parameters at an early postnatal age to predict BPD have been developed with little extensive quantitative validation. The objective of this study is to review and validate clinical prediction models for BPD.MethodsWe searched the main electronic databases and abstracts from annual meetings. The STROBE instrument was used to assess the methodological quality. External validation of the retrieved models was performed using an individual patient dataset of 3229 patients at risk for BPD. Receiver operating characteristic curves were used to assess discrimination for each model by calculating the area under the curve (AUC). Calibration was assessed for the best discriminating models by visually comparing predicted and observed BPD probabilities.ResultsWe identified 26 clinical prediction models for BPD. Although the STROBE instrument judged the quality from moderate to excellent, only four models utilised external validation and none presented calibration of the predictive value. For 19 prediction models with variables matched to our dataset, the AUCs ranged from 0.50 to 0.76 for the outcome BPD. Only two of the five best discriminating models showed good calibration.ConclusionsExternal validation demonstrates that, except for two promising models, most existing clinical prediction models are poor to moderate predictors for BPD. To improve the predictive accuracy and identify preterm infants for future intervention studies aiming to reduce the risk of BPD, additional variables are required. Subsequently, that model should be externally validated using a proper impact analysis before its clinical implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…* Two models [12,13] did not include continuous estimators in their models, so handling of continuous predictor are calculated over 17 models.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study

et al. 2013

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Epidemiology of bronchopulmonary dysplasia

Jensen

Schmidt

2014

Birth Defects Research

309

202

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Bronchopulmonary dysplasia (BPD) is among the most common and serious sequelae of preterm birth. BPD affects at least one-quarter of infants born with birth weights less than 1500 g. The incidence of BPD increases with decreasing gestational age and birth weight. Additional important risk factors include intrauterine growth restriction, sepsis, and prolonged exposure to mechanical ventilation and supplemental oxygen. The diagnosis of BPD predicts multiple adverse outcomes including chronic respiratory impairment and neurodevelopmental delay. This review summarizes the diagnostic criteria, incidence, risk factors, and long-term outcomes of BPD.

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Neonatal chronic lung disease, oxygen dependency, and a family history of asthma

Hagan

Minutillo

French

et al. 1995

Pediatric Pulmonology

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We examined the relationship between a family history of asthma (FHA), neonatal chronic lung disease (CLD), and oxygen dependency in an inception cohort study of all 24- to 30-week gestation infants admitted to the sole tertiary perinatal center in Western Australia. One hundred and forty-four infants were admitted during the study period; 116 had data analyzed, 112 of whom survived to discharge. Respiratory morbidity was common and the prevalence increased with decreasing gestation. Hyaline membrane disease (HMD) occurred in 92 (79%) and CLD (oxygen dependency at 28 days) in 62 (53%); 35 (30%) were oxygen dependent at 36 weeks corrected age, and 16 (14%) were oxygen dependent at term. Thirty-two infants had an FHA which was equally distributed between those infants with and without CLD. Infants with an FHA were more likely to be oxygen dependent at term (relative risk 4.4; 95% Cl 1.7,11.1). Thirty-eight percent of mothers smoked; 68% of their infants developed HMD compared to 89% of those whose mothers did not smoke. Logistic regression identified GA<28 weeks (OR 7.3; 95% Cl 1.4,39), severe HMD (OR 4.8; 95% Cl 1.1,22), and FHA (OR 11.0; 95% Cl 2.3,53) as the only factors associated with an increased risk of being oxygen dependent at term. The duration of supplemental oxygen in infants with CLD was significantly related to decreasing gestation, greater degree of barotrauma, presence of HMD, pregnancy-induced hypertension in the mother, duration of patent ductus arteriosus, and an FHA. An FHA may worsen chronic lung disease in the neonate, but is not involved as a causal factor. Clinicians should be aware of its influence on duration of oxygen supplementation when counselling parents of very preterm infants.

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Occurrence, predictive factors and associated morbidity of broncho-pulmonary dysplasia in a preterm birth cohort

Cited by 25 publications

References 20 publications

Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study

Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study

Epidemiology of bronchopulmonary dysplasia

Neonatal chronic lung disease, oxygen dependency, and a family history of asthma

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