Prematurity and BPD: what general pediatricians should know

Bonadies, Luca; Cavicchiolo, Maria Elena; Priante, Elena; Moschino, Laura; Baraldi, Eugenio

doi:10.1007/s00431-022-04797-x

Cited by 20 publications

(7 citation statements)

References 106 publications

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“…However, caloric fortification should be offered when appropriate and possible with close monitoring of weight gain, linear growth, and head circumference [ 75 , 76 , 77 ]. Collaboration with dietitians well versed in neonatal nutrition should be sought and tracking of weight/length ratio and body mass index are important as part of the global monitoring of well-being [ 78 ].…”

Section: Challenge #2: Multitiered Management Of Bpd-phmentioning

confidence: 99%

“…Therefore, the active participation of a dedicated team of speech and occupational therapists in their ongoing evaluation, as well as for the bedside assessments, is crucial. Promoting safe feeding practices to minimize aspiration is critical to lung health and continued healthy lung function [ 1 , 75 , 78 , 84 ].…”

Section: Challenge #2: Multitiered Management Of Bpd-phmentioning

confidence: 99%

“…Promoting safe feeding practices to minimize aspiration is critical to lung health and continued healthy lung function [1,75,78,84].…”

Section: Treating Comorbidities To Minimize Respiratory Complications...mentioning

confidence: 99%

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Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Varghese,

Altit,

Gubichuk

et al. 2024

JCM

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Advances in perinatal intensive care have significantly enhanced the survival rates of extremely low gestation-al-age neonates but with continued high rates of bronchopulmonary dysplasia (BPD). Nevertheless, as the survival of these infants improves, there is a growing awareness of associated abnormalities in pulmonary vascular development and hemodynamics within the pulmonary circulation. Premature infants, now born as early as 22 weeks, face heightened risks of adverse development in both pulmonary arterial and venous systems. This risk is compounded by parenchymal and airway abnormalities, as well as factors such as inflammation, fibrosis, and adverse growth trajectory. The presence of pulmonary hypertension in bronchopulmonary dysplasia (BPD-PH) has been linked to an increased mortality and substantial morbidities, including a greater susceptibility to later neurodevelopmental challenges. BPD-PH is now recognized to be a spectrum of disease, with a multifactorial pathophysiology. This review discusses the challenges associated with the identification and management of BPD-PH, both of which are important in minimizing further disease progression and improving cardiopulmonary morbidity in the BPD infant.

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Section: Challenge #2: Multitiered Management Of Bpd-phmentioning

confidence: 99%

Section: Challenge #2: Multitiered Management Of Bpd-phmentioning

confidence: 99%

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Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Varghese,

Altit,

Gubichuk

et al. 2024

JCM

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“…With the improvement in neonatal intensive care, survival rates have continuously increased [5], accompanied by growing incidences of long-term complications. Long-term impairment results from the most prevalent morbidities diagnosed at near-term age, affecting several organs, systems and functions, dominated by the cardio-respiratory system and the central nervous system [1,6,7]. Morbidity prevalence is determined by the degree of immaturity as well as the impact of different pre-and postnatal insults [8] including necessary treatments such as mechanical ventilation or oxygen supplementation and the inevitable exposure of an immature immune system to viruses and bacteria.…”

Section: Introductionmentioning

confidence: 99%

Delineating morbidity patterns in preterm infants at near-term age using a data-driven approach

Ciora,

Seegmüller,

Fischer

et al. 2024

BMC Pediatr

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Background Long-term survival after premature birth is significantly determined by development of morbidities, primarily affecting the cardio-respiratory or central nervous system. Existing studies are limited to pairwise morbidity associations, thereby lacking a holistic understanding of morbidity co-occurrence and respective risk profiles. Methods Our study, for the first time, aimed at delineating and characterizing morbidity profiles at near-term age and investigated the most prevalent morbidities in preterm infants: bronchopulmonary dysplasia (BPD), pulmonary hypertension (PH), mild cardiac defects, perinatal brain pathology and retinopathy of prematurity (ROP). For analysis, we employed two independent, prospective cohorts, comprising a total of 530 very preterm infants: AIRR (“Attention to Infants at Respiratory Risks”) and NEuroSIS (“Neonatal European Study of Inhaled Steroids”). Using a data-driven strategy, we successfully characterized morbidity profiles of preterm infants in a stepwise approach and (1) quantified pairwise morbidity correlations, (2) assessed the discriminatory power of BPD (complemented by imaging-based structural and functional lung phenotyping) in relation to these morbidities, (3) investigated collective co-occurrence patterns, and (4) identified infant subgroups who share similar morbidity profiles using machine learning techniques. Results First, we showed that, in line with pathophysiologic understanding, BPD and ROP have the highest pairwise correlation, followed by BPD and PH as well as BPD and mild cardiac defects. Second, we revealed that BPD exhibits only limited capacity in discriminating morbidity occurrence, despite its prevalence and clinical indication as a driver of comorbidities. Further, we demonstrated that structural and functional lung phenotyping did not exhibit higher association with morbidity severity than BPD. Lastly, we identified patient clusters that share similar morbidity patterns using machine learning in AIRR (n=6 clusters) and NEuroSIS (n=8 clusters). Conclusions By capturing correlations as well as more complex morbidity relations, we provided a comprehensive characterization of morbidity profiles at discharge, linked to shared disease pathophysiology. Future studies could benefit from identifying risk profiles to thereby develop personalized monitoring strategies. Trial registration AIRR: DRKS.de, DRKS00004600, 28/01/2013. NEuroSIS: ClinicalTrials.gov, NCT01035190, 18/12/2009.

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“…Individuals who developed bronchopulmonary dysplasia (BPD) are particularly at increased risk of chronic respiratory morbidity including an increased requirement for supplementary oxygen following neonatal discharge, more hospital readmissions particularly for respiratory viral infections, and lung function abnormalities persisting even into adulthood. Sadly, such infants may also suffer hearing and visual impairment, feeding difficulties, growth restriction, and chronic kidney disease [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Exercise Capacity in Very Low Birth Weight Adults: A Systematic Review and Meta-Analysis

Poole,

Harris,

Greenough

2023

Children

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There is an association between very low birth weight (VLBW) and cardiovascular morbidity and mortality in adulthood. Aerobic fitness, measured as the maximal oxygen consumption (VO2 max), is a good indicator of cardiopulmonary health and predictor of cardiovascular mortality. Our aim was to determine the effect of birth weight on aerobic exercise capacity and physical activity. We systematically identified studies reporting exercise capacity (VO2 max and VO2 peak) and physical activity levels in participants born at VLBW aged eighteen years or older compared to term-born controls from six databases (MEDLINE, OVID, EMBASE, CI NAHL, CENTRAL, and Google Scholar). Meta-analysis of eligible studies was conducted using a random effect model. We screened 6202 articles and identified 15 relevant studies, 10 of which were eligible for meta-analysis. VLBW participants had a lower VO2 max compared to their term counterparts (−3.35, 95% CI: −5.23 to −1.47, p = 0.0005), as did VLBW adults who had developed bronchopulmonary dysplasia (−6.08, 95% CI −11.26 to −0.90, p = 0.02). Five of nine studies reported significantly reduced self-reported physical activity levels. Our systematic review and meta-analysis demonstrated reduced maximal aerobic exercise capacity in adults born at VLBW compared to term-born controls.

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Prematurity and BPD: what general pediatricians should know

Cited by 20 publications

References 106 publications

Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Navigating Diagnostic and Treatment Challenges of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia

Delineating morbidity patterns in preterm infants at near-term age using a data-driven approach

Exercise Capacity in Very Low Birth Weight Adults: A Systematic Review and Meta-Analysis

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