Analysis of high risk factors in premature infants with bronchopulmonary dysplasia complicated with extrapulmonary complications
10.3760/cma.j.issn.1673-4912.2024.09.008
- VernacularTitle:支气管肺发育不良早产儿合并肺外并发症的高危因素分析
- Author:
Ruoyang WANG
1
;
Jianhua FU
Author Information
1. 中国医科大学附属盛京医院儿内科，沈阳 110004
- Keywords:
Bronchopulmonary dysplasia;
Extrapulmonary complications;
Risk factors;
Cumulative supplementary oxygen exposure;
Premature infants
- From:
Chinese Pediatric Emergency Medicine
2024;31(9):678-684
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the occurrence and high risk factors of extrapulmonary complications in premature infants with bronchopulmonary dysplasia（BPD），by calculating cumulative supplementary oxygen exposure（CSO）as a predictive value for reference.Methods:The clinical data，laboratory results，incidence and treatment of complications of premature infants with gestational age<32 weeks and birth weight<1 500g in the First Neonatal Internal Medicine Ward at Shengjing Hospital of China Medical University from January 2020 to December 2022 were collected. According to the occurrence of BPD and the severity of BPD, all children were divided into non-BPD group, mild BPD group and moderate to severe BPD group. According to the complications, children with BPD were divided into white matter injury (WMI)/ retinopathy of prematurity (ROP)/ metabolic osteopathy (MBDP) group and non-WMI/ROP/MBDP group.The occurrence and risk factors of these three complications in children with BPD were summarized.And the prediction index was put forward by single factor analysis and Logistic regression analysis.Results:A total of 405 premature infants were included, including 206 cases in non-BPD group, 128 cases in mild BPD group and 71 cases in moderate to severe BPD group.The gestational age and birth weight of BPD preterm infants were smaller than those of non-BPD preterm infants, and the incidences of asphyxia, multi-dose (two or more) pulmonary surfactant use, patent ductus arteriosus and septicemia in moderate to severe BPD group were higher than those in mild BPD group and non-BPD group. The cumulative oxygen therapy time and invasive mechanical ventilation time in moderate to severe BPD group were also longer than those in mild BPD group and non-BPD group.The differences were all statistically significant（ P<0.05）. Among 199 cases of BPD, there were 68 cases in WMI group and 131 cases in non-WMI group,89 cases in ROP group and 110 cases in non-ROP group,131 cases in MBDP group and 68 cases in non-MBDP group.In multivariate Logistic regression analysis，1-28CSO（ OR=2.042，95% CI 1.102-3.783， P=0.023）,cumulative oxygen therapy time（ OR=1.044，95% CI 1.009-1.080， P=0.012）within 28 days after birth and male（ OR=2.711，95% CI 1.123-6.544， P=0.027）were the risk factors of ROP in children with BPD.1-28CSO（ OR=2.124，95% CI 1.193-3.784， P=0.011），birth weight（ OR=0.040，95% CI 0.005-0.352， P=0.004）and late-onset sepsis（ OR=2.165，95% CI 1.027-4.567， P=0.042）were the risk factors of MBDP in children with BPD.The receiver operating characteristic curve analysis showed that the areas under the curve of 1-28CSO for BPD combined with ROP and MBDP were 0.872（95% CI 0.824-0.921）and 0.779（95% CI 0.711-0.846）, respectively, the sensitivities were 70.8% and 77.9%, the specificities were 88.2% and 72.0%,respectively, and the critical values was 2.900 and 2.125,respectively. Conclusion:The increase of cumulative oxygen therapy time and male may increase the risk of BPD with ROP, low birth weight and the occurrence of late-onset sepsis may increase the risk of BPD with MBDP, and 1-28CSO is a common risk factor for both.1-28CSO has a high predictive value in early evaluation of BPD with ROP and MBDP.
