Abstract
Aims: To analyse influence of perinatal data and early morbidity on moderate-severe BPD in ELGAN with birth weight(BW)< 1000g.
Methods: This is a retrospective cohort of all ELGAN with BW< 1000g alive at 36w postmenstrual age born between 2004-2009 in our unit. BPD was defined as moderate-severe following NICHDNHLBI workshop definitions.
Results: 201 infants were included. Moderatesevere BPD prevalence was 41.7%. BPD group had lower gestational age(GA) and BW(25.5±1.1 vs 26.2±1w p=0.000; 749±123.3 vs 830.4±116.7g p=0.000) and higher rate of male sex(59.5 vs 47% p=0.039) and vaginal delivery(45.2 vs 22.7% p=0.012). We didn't find differences in antenatal steroids or chorioamnionitis. BPD patients needed more delivery room intubation(75 vs 55.5% p=0.006), higher oxygen(0.52±0.24 vs 0.41±0.21 p=0.000) and had lower initial PEEP(4.2±0.6 vs 4.4±0.6H2O cm p=0.01). They had higher rates of RDS, early hypotension, symptomatic PDA and PDA requiring surgery(86.9 vs 76% p=0.044; 60.7 vs 27.3% p=0.000; 66.6 vs 56.4% p=0.000; 46.4 vs 11.9% p=0.000). In BPD group Ureaplasma urealitycum bronchopneumonia was higher without significance(19 vs 6.8% p=0.06). Late sepsis and pneumonia(76.1 vs 58.9% p=0.000; 70.2 vs 18.8% p=0.000), severe HIV and hemorrhagic periventricular infarction rates were more frequent(8.3 vs 1.7% p=0.000; 5.9 vs 1.7% p=0.000).
More days on mechanical ventilation and oxygen therapy were observed in BPD group(29.8±20.5 vs 11.2±12.9 p=0.000; 102.2±29.8 vs 47.2±20.8 p=0.000; 6.6±7.1 vs 3±2.8 p=0.001).
Conclusion: Low GA and BW, male sex, early respiratory morbidity, respiratory infection, symptomatic PDA are risk factors for BPD in ELGAN. Could we design new strategies controlling these factors to prevent BPD development?.
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Torres, S., Fernández, E., Rodriguez, P. et al. 1349 Risk Factors Associated with Bronchopulmonary Displasia (BPD) in Extremely Low Gestational Age Newborns (ELGAN). Pediatr Res 68 (Suppl 1), 668 (2010). https://doi.org/10.1203/00006450-201011001-01349
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DOI: https://doi.org/10.1203/00006450-201011001-01349