Clinical Characteristics And Predictive Factors Of Bronchopulmonary Dysplasia In Extremely Low Birth Weight Infants

Objection:To know the clinical characteristics and outcomes of bronchopulmonary dysplasia(BPD)with different degrees of extremely low birth weight infants(ELBWIs),identify the risk factors of severe BPD(s BPD),and so as to guide the prevention and treatment of BPD and improve the prognosis of premature infants.Methods: Detailed antenatal and postnatal data were abstracted for Extremely-low-birth-weight infants who were admitted to NICU in the Shengjing Hospital Affiliated to China Medial University and diagnosed as BPD from Jan.2015 to Dec.2019.According to the severity standard of BPD,it was divided into mild,moderate and s BPD groups.Compared differences and identify the risk factors of s BPD.Result: Of the total 165 ELBWIs met the criterion,with an average gestational age of 28w(24-33w),an average birth weight of 861g(498-999g),and a male/female ratio of84/81(1:1),71 cases of twins(43.0%).There were 37(22.4%)cases of Mild BPD,75(45.5%)cases of moderate BPD,53(32.1%)cases of s BPD.In the same period,there was 95 ELBWIs without BPD who were hospitalized.(1)With the decrease of gestational age,the incidence rate of BPD during the hospitalization and the proportion of s BPD in corresponding gestational age gradually increased.The incidence rates of BPD of the group of extremely premature infants(GA<28w)(82.6%)and the group of BW<750g(84.8%)were obviously higher than the group of GA≥28w(53.0%)and the group of BW≥750g(60.4%),p=0.000 and 0.006.(2)The proportion of male(67.9%),invasive ventilation within one week(94.3%),continuous invasive mechanical ventilation≥4w(55.6%),Glucocorticoid(56.6%),PDA with surgical ligation(41.7%),NEC(15.1%),LOS(39.6%)and fungal infection(42.9%)in s BPD was significantly higher than that in mild-moderate BPD(42.9%,83.0%,20.5%,12.5%,17.0%,4.5%,20.5% and 13%),P =0.003,0.046,0.000,0.000,0.024,0.040,0.010 and 0.027;The time of invasive ventilation(39d,IQR,26.5-54.5d),parenteral nutrition(52.9 ± 24.2d)and antibiotic(28d,IQR,15-39.5d)was significantly longer than that of mild-moderate BPD(5.5d,IQR,1-21 d,37.5 ± 15.4d,11 d,IQR,5-18.8d),P = 0.000;the number of blood transfusion(15 times,IQR,10.5-19times)was significantly more than that of mild-moderate BPD(9 times,IQR,6-12 times),P = 0.000.(3)The hospitalization time of s BPD(94 ± 19d)was significantly longer than that of mild-moderate BPD(74 ± 17d),the average postmenstruation age at discharge(41w,IQR,39-42w)was significantly higher than that of mild-moderate BPD(38w,IQR,37-39w),and the proportion of home oxygen therapy(60.9%)was significantly higher than that of mild-moderate BPD(15.2%),all P = 0.000.(4)Multivariate logistic regression analysis showed that male(OR= 2.599,95% CI: 1.063-6.353)and glucocorticoid(OR= 8.536,95% CI: 3.206-22.729)were the predictive factors of s BPD.male and requirement of the glucocorticoid were the predictive factors of s BPD.Conclusion: The incidence rate of BPD of extremely premature infants was obviously higher.Compared with the mild-moderate BPD groups,the treatment time of the s BPD group was longer and the incidence rate of complications of premature infants was higher.And the risk of s BPD of male infants and those receiving the treatment of glucocorticoid was higher.