Analysis of Incidence and Risk Factors of Severe Bronchopulmonary Dysplasia (sBPD) among Very Low Birth Weight Infants

Background: Although we’ve made big strides in perinatal care, BPD remains the most common late morbidity of preterm birth, but many controversies persist regarding how to best define BPD, grade its severity, and prevent disease.

Objectives: The aim was to determine the current incidence and analyze possible risk factors of severe BPD(sBPD) in very-low-birth-weight (VLBW) infants.

Materials and Methods:This was a retrospective study by reviewing medical records of all VLBW infants (BW ≤ 1500 g) admitted to NICU of Chang Gung Children’s Hospital over 2 years period. All VLBW infants diagnosed for BPD were included and data were retrieved retrospectively and analyzed for maternal medical and obstetric and neonatal risk factors using logistic regression.

Results: Of the 472 VLBW infants who were enrolled, 412 (87%) survived. BPD was noted in 247 (59.9%) of them. There were 14.3%, 38.1% and 7.5% of mild, moderate, and severe BPD, respectively. Neonates of GA≤ 25 wks and 26–28 wks had increased odds ratio of 8.49 and 3.19 for the development of severe BPD, compared to those of 29 wks or more. Pulmonary hypertension complicates the course in up to 25% of patients with sBPD. By univariant analysis for sBPD, PDA, sepsis, and ROP are strongly associated with the development of sBPD (P <0.05). However, using multiple logistic regression analyses for sBPD, only chorioamnionitis [odds ratio (OR), 2.48; confidence interval (CI), 1.32 to 4.7], birth weight (OR, 0.99; CI, 0.996 to 0.999), and duration of ventilation (OR, 1.06; CI, 1.04 to 1.08) were factors predictive of development of sBPD.

Conclusion: The incidence of severe BPD among VLBW infants was 7.5%. Infants of