Risk factors and bronchopulmonary dysplasia severity: data from the Spanish Bronchopulmonary Dysplasia Research Network

Abstract

GEIDIS is a national based research-net registry of patients with bronchopulmonary dysplasia (BPD) from public and private Spanish hospitals. It was created to provide data on the clinical characterization and follow up of infants with BPD until adulthood. The purpose of this observational study was to analyze the characteristics and the impact of perinatal risk factors on BPD severity. The study included 1,780 patients diagnosed with BPD. Of the total sample, 98.6% were premature (less than 37 weeks) and 89,4% less than 30 weeks of gestation. The median gestational age was 27.1 weeks (25.8-28.5) and median birth weight 890 g (740-1,090 g). 52.3% (n=931) were classi ed as mild (type 1), 25.1% (n=447) were moderate (type 2), and 22.6% (n=402) severe BPD (type 3).Most pre-and postnatal risk factors for type 2/3 BPD were associated with the length of exposure to mechanical ventilation (MV). Independent prenatal risk factors were male gender, oligohydramnios, and intrauterine growth restriction. Postnatal risk factors included the need for FiO 2 of > 0.30 in the delivery room, two or more doses of surfactant administration, nosocomial pneumonia, and the length of exposure to MV.Conclusions: In this national based research-net registry of BPD patients the length of MV is the most important risk factor associated with type 2/3 BPD. Among type 3 BPD patients, those who required an FiO 2 > .30 at 36 weeks' postmenstrual age had a higher morbidity, during hospitalization and at discharge, compared to those with nasal positive pressure but FiO 2 < .30.

Risk prediction of bronchopulmonary dysplasia in preterm infants by the nomogram model

“…The pathogenesis of BPD is complex, with the underlying cause being impaired development of the immature lung in response to inflammation, hyperoxia, and other damaging factors ( 11 , 12 ). Prenatal and neonatal factors have been associated with BPD ( 13 , 14 ). The prenatal factors are related to the lack of antenatal steroid therapy, chorioamnionitis, and maternal hypertension ( 13 , 14 ).…”

“…Prenatal and neonatal factors have been associated with BPD ( 13 , 14 ). The prenatal factors are related to the lack of antenatal steroid therapy, chorioamnionitis, and maternal hypertension ( 13 , 14 ). Neonatal factors include gestational age, birth weight, and postdelivery resuscitation ( 13 , 14 ).…”

“…The prenatal factors are related to the lack of antenatal steroid therapy, chorioamnionitis, and maternal hypertension ( 13 , 14 ). Neonatal factors include gestational age, birth weight, and postdelivery resuscitation ( 13 , 14 ). The independent prenatal risk factors may be oligohydramnios, male gender, and intrauterine growth restriction ( 14 , 15 ).…”

“…Neonatal factors include gestational age, birth weight, and postdelivery resuscitation ( 13 , 14 ). The independent prenatal risk factors may be oligohydramnios, male gender, and intrauterine growth restriction ( 14 , 15 ). Postnatal risk factors seem to be the length of exposure to mechanical ventilation, nosocomial pneumonia, and the necessity for FiO 2 of more than 0.30 in the delivery room ( 14 , 15 ).…”

“…The independent prenatal risk factors may be oligohydramnios, male gender, and intrauterine growth restriction ( 14 , 15 ). Postnatal risk factors seem to be the length of exposure to mechanical ventilation, nosocomial pneumonia, and the necessity for FiO 2 of more than 0.30 in the delivery room ( 14 , 15 ). It is important to prevent and control the occurrence of BPD if the risk of BPD development can be identified and assessed early.…”