The Natural History of Bronchopulmonary Dysplasia

McEvoy, Cindy T.; Aschner, Judy L.

doi:10.1016/j.clp.2015.08.014

Cited by 35 publications

(26 citation statements)

References 87 publications

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“…BPD is the most common form of chronic lung disease in infancy. 37 At present, BPD primarily occurs in extremely premature infants (23-29 weeks of gestation) born during the late canalicular/early saccular stage of lung development and is characterized by arrested alveolarization, abnormal microvascular angiogenesis, and inter-alveolar fibrosis. 38 With progress at the medical treatment level, an increasing number of premature BPD infants are born, and they are at increased risk for numerous complications and re-hospitalization since BPD affects many vital organ systems.…”

Section: Discussionmentioning

confidence: 99%

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

Rocha¹,

Flôr-de-Lima

Machado

et al. 2018

Amer J Perinatol

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Section: Discussionmentioning

confidence: 99%

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

Rocha¹,

Flôr-de-Lima

Machado

et al. 2018

Amer J Perinatol

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“…CNN data is limited in its tracking of patients post-discharge, but does provide a helpful starting point on the distribution of patients discharged from hospital. The published literature provides additional neonatal patient information on discharge rates, ventilation duration, long-term complication rate, and health care utilization [2,6,7]. However much of the data were reported as aggregated means from small cohorts, and only one study stratifies according to BPD severity [2].…”

Section: Methodsmentioning

confidence: 99%

“…Mortality risk by BPD status was found to significantly impact the final sample distribution. We concluded, on the basis of expert opinion and the published literature [4,6,7], that the mortality risk is non-normally distributed by patient characteristics and is very likely to be a competing risk of BPD status at 36 weeks. Consequentially, we applied this non-Gaussian distribution of mortality risk to the final model by applying BPD-correlated ranks to the random effects model to estimate mortality and back transformed to a uniform distribution to apply to the final joint density function [9].…”

Section: Methodsmentioning

confidence: 99%

Lifetime patient outcomes and healthcare utilization for Bronchopulmonary dysplasia (BPD) and extreme preterm infants: a microsimulation study

et al. 2020

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Background: Bronchopulmonary dysplasia (BPD) is among the most severe chronic lung diseases and predominantly affects premature infants. There is a general understanding of BPD's significant impact on the short-term outcomes however there is little evidence on long-term outcomes. Our study estimates the lifetime clinical outcomes, quality of life, and healthcare costs of BPD and associated complications. Methods: We developed a microsimulation model to estimate lifetime clinical and economic burden of BPD among extreme preterm infants (≤28 weeks gestational age at birth) and validated it against the best available Canadian data. We further estimate the cumulative incidence of major complications associated with BPD, differentiated by BPD severity and gestational age category. Results: We find, on average, patients with BPD and resulting complications will incur over CAD$700,000 in lifetime health systems costs. We also find the average life expectancy of BPD patients to be moderately less than that of the general population and significant reductions in quality-adjusted life year due to major complications. Healthcare utilization and quality of life measures vary dramatically according to BPD severity, suggesting significant therapeutic headroom for interventions that can prevent or mitigate the effects of BPD for patients. Conclusions: Our study adds a significant expansion of existing evidence by presenting the lifetime burden of BPD based on key patient characteristics. Given the extreme cost burden at the earliest stage of life and lifetime negative impact on quality of life, there is larger headroom for investment in prevention and mitigation of severe BPD than is currently available.

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“…Even ‘mature’ preterm infants born at 28–36 weeks’ gestation have significantly higher rates of behavioural, cognitive and psychiatric deficits compared with term-born peers 2–7. Beyond neurodevelopmental abnormalities, children born preterm demonstrate elevated rates of lung disease8 9 and maladaptive growth 10 11. ‘Prematurity’, however, is not uniformly predictive or well-understood in the causal pathway of morbidity.…”

Section: Introductionmentioning

confidence: 99%

Cohort profile: the Neonatal Intensive Care Unit Hospital Exposures and Long-Term Health (NICU-HEALTH) cohort, a prospective preterm birth cohort in New York City

et al. 2019

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PurposeThe Neonatal Intensive Care Unit Hospital Exposures and Long-Term Health (NICU-HEALTH) longitudinal preterm birth cohort studies the impact of the NICU exposome on early-life development. NICU-HEALTH collects multiple biospecimens, complex observational and survey data and comprehensive multisystem outcome assessments to allow measurement of the impact of modifiable environmental exposures during the preterm period on neurodevelopmental, pulmonary and growth outcomes.ParticipantsModerately preterm infants without genetic or congenital anomalies and their mothers are recruited from an urban academic medical centre level IV NICU in New York City, New York, USA. Recruitment began in 2011 and continues through multiple enrolment phases to the present with goal enrolment of 400 infants. Follow-up includes daily data collection throughout the NICU stay and six follow-up visits in the first 2 years. Study retention is 77% to date, with the oldest patients turning age 8 in 2019.Findings to dateNICU-HEALTH has already contributed significantly to our understanding of phthalate exposure in the NICU. Phase I produced the first evidence of the clinical impact of phthalate exposure in the NICU population. Further study identified specific sources of exposure to clinically relevant phthalate mixtures in the NICU.Future plansFollow-up from age 3 to 12 is co-ordinated through integration with the Environmental Influences on Child Health Outcomes (ECHO) programme. The NICU-HEALTH cohort will generate a wealth of biomarker, clinical and outcome data from which future studies of the impact of early-life chemical and non-chemical environmental exposures can benefit. Findings from study of this cohort and other collaborating environmental health cohorts will likely translate into improvements in the hospital environment for infant development.Trial registration numbersThis observational cohort is registered with ClinicalTrials.gov (NCT01420029andNCT01963065).

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The Natural History of Bronchopulmonary Dysplasia

Cited by 35 publications

References 87 publications

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

Lifetime patient outcomes and healthcare utilization for Bronchopulmonary dysplasia (BPD) and extreme preterm infants: a microsimulation study

Cohort profile: the Neonatal Intensive Care Unit Hospital Exposures and Long-Term Health (NICU-HEALTH) cohort, a prospective preterm birth cohort in New York City

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