Prospective study of risk factors for preterm infants with bronchopulmonary dysplasia
10.3760/cma.j.issn.2095-428X.2015.10.010
- VernacularTitle:早产儿支气管肺发育不良危险因素前瞻性研究
- Author:
Yanli REN
;
Xiangyong KONG
;
Zhifang DU
;
Zhichun FENG
- Publication Type:Journal Article
- Keywords:
Bronchopulmonary dysplasia;
Risk factor;
Infant,newborn;
Prospective study
- From:
Chinese Journal of Applied Clinical Pediatrics
2015;30(10):757-760
- CountryChina
- Language:Chinese
-
Abstract:
Obgective To explore the risk factors of preterm infants with bronchopulmonary dysplasia(BPD).Methods A prospective cohort study was conducted to analyze the risk factors of preterm infants with BPD.Preterm infants (gestational age < 32 weeks,and admission within 24 h since birth,and survival time more than 28 d since birth) who were sent to the Ward of Extremely Preterm Infants in Bayi Children's Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital of Southern Medical University were enrolled from November 2013 to May 2014.According to the diagnostic criteria of BPD,the subjects were divided into 2 groups(BPD group and non-BPD group).Factors such as maternal information,neonatal basic information,neonatal diseases and treatments were compared between the 2 groups.Risk factors of preterm infants with BPD were analyzed by using t test,Chi-square test,Fisher's exact probability method and Logistic regression analysis.Results (1) A total of 298 cases were enrolled in this study.Among these infants,180 cases were male and 118 cases were female.The gestational age ranged from 25.6 to 31.9 weeks with the average age of (29.9 ± 1.4) weeks and the birth weights ranged from 740 to 2 300 g with the average weight of (1 428.3 ± 289.0) g.There were 19 cases of extremely low birth weight and 175 cases of very low birth weight.Sixty-nine cases of these infants were diagnosed as BPD (43 cases were mild,10 cases were moderate,16 cases were severe) with incidence of 23.2%.(2)The incidence of BPD was negatively related to gestational age and birth weight:the incidence of BPD in preterm infants with gestational age < 28 weeks,28-30 weeks and ≥ 30-32 weeks were 70.4%,41.9% and 6.2%;the incidence of BPD in preterm infants with birth weight < 1 000 g,1 000-1 500 g and ≥ 1 500-1 800 g were 78.9%,29.5% and 8.8%.(3) Multivariate Logistic regression found gestational age (OR =4.52),birth weight (OR =3.38),gender (OR =3.04),cytomegalovirus infection (OR =55.27),duration of invasive ventilation ≥ 7 d (OR =3.22),the highest concentration of inspired oxygen ≥400 mL/L (OR =4.14),patent ductus arteriosus(PDA) in need of surgical ligation (OR =7.30),and transfusion of packed red blood cells within 14 d since birth (OR =3.51) were the independent risk factors of BPD (all P < 0.05).(4) Factors such as birth weight (P =0.015),duration of invasive ventilation (P =0.003),duration of inspired oxygen (P =0.000),and PDA in need of surgical ligation or not(P =0.017) were related to the severity of BPD.Conclusions BPD is a multifactorial disease.Taking effective measures to control risk factors is the key for preventing BPD.