Bronchopulmonary dysplasia in very low birth weight infants.
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Date
2009-07
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Abstract
Objective. To determine the risk factors for development of bronchopulmonary dysplasia (BPD) by evaluating mild and
moderate/severe BPD in extramural neonates with a birth weight <1501 g. Methods. A case-control study was conducted
between January 1, 2004- December 31, 2006. Patients with BPD and without BPD were compared. Bronchopulmonary
dysplasia was diagnosed and classified according to the Bancalari criteria. One-hundred and six (106) extramural
premature infants with a birth weight <1501 g and admitted to the Neonatal Unit in the first three days of life and survived for
more than 28 postnatal days were included. Patients with multiple congenital anomalies and complex cardiac pathologies
were excluded. The maternal and neonatal risk factors, clinical features, mechanical ventilation treatment were compared.
The principal risk factors for BPD development were analyzed and followed by logistic regression test. Results. The
diagnosis was mild BPD in 27 of the 106 patients and moderate/severe BPD in 29. The incidence of BPD was 52.8%. Fifty
of 106 patients had no BPD. Analysis of risk factors revealed that gestational age ≤28 weeks (p=0.019), birth weight ≤1000
g (p=0.007), hypothermia (p=0.003), acidosis (p=0.003) and hypotension (p=0.005) at admission, respiratory distress
syndrome (RDS) ( p<0.001), mechanical ventilation therapy (p<0.001), surfactant therapy (p=0.005), higher amount of mean
fluid therapy on 7th days (p=0.008), nosocomial infection (p<0.001), higher amount of mean packed red cell transfusions
(p<0.001) and more than two packed red cell transfusions (p=0.033) were risk factors associated with the development of
BPD. Multivariant logistic regression analysis showed acidosis at admission (OR 5.12, 95%CI 1.17–22.27, p=0.029),
surfactant treatment (OR 7.53, 95%CI 2.14–26.45, p=0.002), nosocomial infections (OR 4.66, 95%CI 1.27–17.12, p=0.02)
and PDA (OR 9.60, 95%CI 2.23–41.22, p=0.002) were risk factors increasing the severity of BPD. Conclusion. The most
important risk factors for BPD development in our study were RDS and nosocomial infections while the presence of
acidosis at admission, surfactant administration, nosocomial infections and the presence of PDA were the most important
risk factors regarding BPD severity. Presence of acidosis at admission as a risk factor emphasized the importance of
suitable transport conditions for premature infants.
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Keywords
Bronchopulmonary dysplasia, Neonatal chronic lung disease, Very low birth weight infants, Respiratory distress syndrome, Acidosis
Citation
Demirel Nihal, Bas Ahmet Yagmur, Zenciroglu Ayesegul. Bronchopulmonary dysplasia in very low birth weight infants. Indian Journal of Pediatrics. 2009 Jul; 76(7): 695-698.