Clinical Diagnosis and Treatment Analysis of Bronchopulmonary Dysplasia in Preterm Infants and Construction of Prognostic Prediction Model
10.13241/j.cnki.pmb.2025.14.004
- VernacularTitle:早产儿支气管肺发育不良的临床诊治分析及预后预测模型的构建
- Author:
Zhi-jun SONG
1
;
Hao LUO
1
;
Xiao-yun CHU
1
;
Xiao-yue ZHANG
1
;
Bo-wen WENG
1
;
Cheng CAI
1
Author Information
1. 上海交通大学医学院附属儿童医院上海市儿童医院新生儿科 上海 200062
- Publication Type:Journal Article
- Keywords:
Bronchopulmonary dysplasia;
Risk factors;
Premature infants;
Clinical diagnosis and treatment analysis;
Severity prediction model
- From:
Progress in Modern Biomedicine
2025;25(14):2269-2278
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical management,complications,and prognostic prediction model of bronchopulmonary dysplasia(BPD)in preterm infants.Methods:A total of 854 very preterm infants(gestational age ≤ 32 weeks)admitted to the Neonatal Intensive Care Unit(NICU)of Shanghai Children's Hospital from January 2018 to December 2022 were retrospectively enrolled.After applying inclusion and exclusion criteria,713 infants were included.Based on the 2018 National Institute of Child Health and Human Development(NICHD)diagnostic criteria for BPD,the cohort was divided into a BPD group(n=164)and a non-BPD group(n=549).Clinical data of infants and maternal characteristics were compared between groups.Univariate and stepwise multivariate logistic regression analyses were performed to identify independent risk factors for BPD and evaluate clinical management.A nomogram model was subsequently developed to predict BPD prognosis.Results:Gestational age,duration of non-invasive ventilation,total oxygen therapy time,total hospital stay,hemodynamically significant patent ductus arteriosus(hsPDA),maximum diameter of patent ductus arteriosus(PDA),fetal growth restriction(FGR),use of vasoactive agents,and proportion of pulmonary surfactant administration were identified as independent risk factors for BPD(all P＜0.05,OR＞0).The nomogram model demonstrated excellent predictive performance,with an area under the receiver operating characteristic curve(AUC)of 0.93 and a calibration curve slope approaching 1.The Hosmer-Lemeshow goodness-of-fit test indicated satisfactory model calibration(x2=8.2865,P=0.406).Conclusion:Gestational age,non-invasive ventilation duration,total oxygen therapy time,total hospital stay,hsPDA,PDA maximum diameter,FGR,vasoactive agents,and pulmonary surfactant use are critical predictors of BPD in preterm infants.The prognostic models for BPD incidence and severity,constructed based on these factors,exhibit strong predictive accuracy and may serve as a valuable clinical tool for risk stratification and early intervention.
