[Influencing factors for the development and severity of bronchopulmonary dysplasia in preterm infants with a gestational age of <32 weeks and a birth weight of <1 500 g].

Abstract

OBJECTIVES:

To study the influencing factors for the development and severity of bronchopulmonary dysplasia (BPD) in preterm infants with a gestational age of <32 weeks and a birth weight of <1 500 g.

METHODS:

A retrospective analysis was performed on the medical data of preterm infants with a gestational age of <32 weeks and a birth weight of <1 500 g who were admitted to Women and Children's Hospital Affiliated to Xiamen University from January 1, 2017 to December 31, 2021. According to oxygen dependence on day 28 after birth, they were divided into two groups: BPD (n=218) and non-BPD (n=142). According to disease severity based on oxygen concentration required at the corrected age of 36 weeks or at discharge, the infants with BPD were divided into two groups: mild BPD (n=154) and moderate/severe BPD (n=64). Indices such as perinatal data and nutritional status were compared between groups. The multivariate logistic regression analysis was used to determine the influencing factors for BPD and its severity.

RESULTS:

The incidence rate and severity of BPD increased with the reduction in gestational age and birth weight (P<0.05). The multivariate logistic regression analysis showed that a long duration of invasive mechanical ventilation (OR=1.320, P<0.05), hemodynamically significant patent ductus arteriosus (OR=2.032, P<0.05), and a prolonged time to reach oral calorie goal of 110 kcal/(kg·d) (OR=1.041, P<0.05) were risk factors for BPD, while an older gestational age was a protective factor against BPD (OR=0.535, P<0.05). Early-onset sepsis (OR=2.524, P<0.05) and a prolonged time to reach oral calorie goal of 110 kcal/(kg·d) (OR=1.029, P<0.05) were risk factors for moderate/severe BPD, while a high mean weight growth velocity was a protective factor against moderate/severe BPD (OR=0.906, P<0.05).

CONCLUSIONS:

The incidence rate and severity of BPD in preterm infants with a gestational age of <32 weeks and a birth weight of <1 500 g can be reduced by shortening the duration of invasive mechanical ventilation, giving early treatment of early-onset sepsis and hemodynamically significant patent ductus arteriosus, adopting active enteral nutritional strategies, and increasing mean weight growth velocity.

• Authors: Jing Huang, Xin-Zhu Lin, Zhi Zheng, Lian Wang, Fen-Fen Ou
• Journal: Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics (Zhongguo Dang Dai Er Ke Za Zhi) Vol. 24 Issue 12 Pg. 1326-1333 (Dec 15 2022) ISSN: 1008-8830 [Print] China
• Vernacular Title: 胎龄<32周且出生体重<1 500 g早产儿支气管肺发育不良的发生及其严重程度的影响因素.
• PMID: 36544414 (Publication Type: English Abstract, Journal Article)

Chemical References

• Oxygen

Topics

• Infant
• Pregnancy
• Child
• Infant, Newborn
• Humans
• Female
• Infant, Premature
• Birth Weight
• Bronchopulmonary Dysplasia (etiology, epidemiology)
• Gestational Age
• Ductus Arteriosus, Patent
• Retrospective Studies
• Sepsis (complications)
• Oxygen
• Infant, Very Low Birth Weight