High Risk Factors Analysis In Bronchopulmonary Dyspiasia Of Premature Infants

Objective:To analyze the clinical characteristics of brochopulmonary dysplasia(BPD) in preterm infants of Neonatal Intensive Care units (NICU) in Shandong Provincial Hospital. Disscuss the risk factors for development of BPD and severity of BPD, and to provide the helpful clinical information for the prevention, diagnosis and treatment of BPD.Methods:Data were retrospective collected from NICU in Shandong Provincial Hospital between Jan.2010to Dec.2012. All babies whose gestational age was<37w and survived over28days were included in this study. BPD was diagnosed according to the Bancalari criteria which was oxygen dependency at28days of age.150cases were randomly selected in the non-BPD patients. All clinical features, maternal and neonatal risk factors were compared between BPD and non-BPD group. BPD was classified as mild, moderate and severe according to Bancalari criteria. All clinical features, maternal and neonatal risk factors were compared between mild group and moderate/severe group.Result:59cases met the criteria of BPD among1453cases. The incidence of BPD was4.06%. Among59cases,3were excluded because of incomplete data,56cases were included. Multivariate logistic regression analysis showed the risk of factors for BPD were birth weight, mechanical ventilation and blood transfusion.18of the56patients (32.1%)had mild BPD while38of56patients (77.9%)had moderate/severe BPD. The independent risk factors for severity of BPD included duration of mechanical ventilation>7days,the duration of CPAP and oxygen provided, the volume and frequency of blood transfusion.48of the56patients (81.4%) were males while11of56patients (19.6%) were females. The average gestational age (GA) of56cases was29.68±1.473w, the average birth weight (BW) was1245.18±280.914g. The composition ratio of BPD in GA<28w,28w-,30w-,32w-37w were10.7%,42.9%,39.3%,7.1%. The composition ratio of BPD in BW<1000g,1000g～,1500g-,2000g～were14.3%,71.4%,12.5%,1.8%. The average of duration of mechanical ventilation, CPAP, oxygen were4.80,4.21d, The average of duration of oxygen43.03±15.505d. The average of the volume and frequency of blood transfusion were92.30±65.303ml,3.43±2.319. The average of everyday milk were260.07±154.079ml, and the average of weight2035.13±439.221g when leave the hospital。Conclusions:In this study,, the two groups of the there are11factors in BPD was statistically significant, the influence of these factors include male, gestational age, birth weight,1min apgar score<8,5min apgar score<8, PDA, ROP, NRDS, mechanical ventilation, blood transfusion were statistically significant compare between the BPD and the non-BPD group. The birth weight, mechanical ventilation and blood transfusion of red blood cells are high risk factors of the BPD, reduce or avoid premature mechanical ventilation, take the lung protective ventilation strategy, helps to reduce blood transfusion reasonably BPD. risk factors that compared between mild group and moderate/severe group were conclude the duration of mechanical ventilation≥7days, CPAP, the duration of oxygen, blood transfusion. Logistic regression analysis showed that this six factors has no statistical significance..