Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China
Abstract Bronchopulmonary dysplasia (BPD) is the most common complication of prematurity involving both pre- and post-natal factors. A large, prospective, longitudinal cohort study was conducted to determine whether inflammation-related factors are associated with an increased risk of BPD in preterm...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-10-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-45216-x |
| _version_ | 1797560032739459072 |
|---|---|
| author | Yan-ping Xu Zheng Chen Robert M. Dorazio Guan-nan Bai Li-zhong Du Li-ping Shi |
| author_facet | Yan-ping Xu Zheng Chen Robert M. Dorazio Guan-nan Bai Li-zhong Du Li-ping Shi |
| author_sort | Yan-ping Xu |
| collection | DOAJ |
| description | Abstract Bronchopulmonary dysplasia (BPD) is the most common complication of prematurity involving both pre- and post-natal factors. A large, prospective, longitudinal cohort study was conducted to determine whether inflammation-related factors are associated with an increased risk of BPD in preterm infants who were born at a gestational age < 32 weeks, < 72 h after birth and respiratory score > 4. The study included infants from 25 participating hospitals in China between March 1, 2020 and March 31, 2022. The primary outcomes were BPD and severity of BPD at 36 weeks post-menstrual age. A total of 1362 preterm infants were enrolled in the study. After exclusion criteria, the remaining 1088 infants were included in this analysis, of whom, 588 (54.0%) infants were in the BPD group and 500 (46.0%) were in the non-BPD group. In the BPD III model, the following six factors were identified: birth weight (OR 0.175, 95% CI 0.060–0.512; p = 0.001), surfactant treatment (OR 8.052, 95% CI 2.658–24.399; p < 0.001), mean airway pressure (MAP) ≥ 12 cm H2O (OR 3.338, 95% CI 1.656–6.728; p = 0.001), late-onset sepsis (LOS) (OR 2.911, 95% CI 1.514–5.599; p = 0.001), ventilator-associated pneumonia (VAP) (OR 18.236, 95% CI 4.700–70.756; p < 0.001) and necrotizing enterocolitis (NEC) (OR 2.725, 95% CI 1.182–6.281; p = 0.019). Premature infants remained at high risk of BPD and with regional variation. We found that post-natal inflammation-related risk factors were associated with an increased risk of severe BPD, including LOS, VAP, NEC, MAP ≥ 12 cm H2O and use of surfactant. |
| first_indexed | 2024-03-10T17:54:43Z |
| format | Article |
| id | doaj.art-438bf77f214d4b72a856dc88ff477c62 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T17:54:43Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-438bf77f214d4b72a856dc88ff477c622023-11-20T09:14:08ZengNature PortfolioScientific Reports2045-23222023-10-0113111010.1038/s41598-023-45216-xRisk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in ChinaYan-ping Xu0Zheng Chen1Robert M. Dorazio2Guan-nan Bai3Li-zhong Du4Li-ping Shi5NICU, Children’s Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child HealthNICU, Children’s Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child HealthClinical Research Center, Children’s Hospital, Zhejiang University School of MedicineDepartment of Child Health Care, Children’s Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child HealthNICU, Children’s Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child HealthNICU, Children’s Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child HealthAbstract Bronchopulmonary dysplasia (BPD) is the most common complication of prematurity involving both pre- and post-natal factors. A large, prospective, longitudinal cohort study was conducted to determine whether inflammation-related factors are associated with an increased risk of BPD in preterm infants who were born at a gestational age < 32 weeks, < 72 h after birth and respiratory score > 4. The study included infants from 25 participating hospitals in China between March 1, 2020 and March 31, 2022. The primary outcomes were BPD and severity of BPD at 36 weeks post-menstrual age. A total of 1362 preterm infants were enrolled in the study. After exclusion criteria, the remaining 1088 infants were included in this analysis, of whom, 588 (54.0%) infants were in the BPD group and 500 (46.0%) were in the non-BPD group. In the BPD III model, the following six factors were identified: birth weight (OR 0.175, 95% CI 0.060–0.512; p = 0.001), surfactant treatment (OR 8.052, 95% CI 2.658–24.399; p < 0.001), mean airway pressure (MAP) ≥ 12 cm H2O (OR 3.338, 95% CI 1.656–6.728; p = 0.001), late-onset sepsis (LOS) (OR 2.911, 95% CI 1.514–5.599; p = 0.001), ventilator-associated pneumonia (VAP) (OR 18.236, 95% CI 4.700–70.756; p < 0.001) and necrotizing enterocolitis (NEC) (OR 2.725, 95% CI 1.182–6.281; p = 0.019). Premature infants remained at high risk of BPD and with regional variation. We found that post-natal inflammation-related risk factors were associated with an increased risk of severe BPD, including LOS, VAP, NEC, MAP ≥ 12 cm H2O and use of surfactant.https://doi.org/10.1038/s41598-023-45216-x |
| spellingShingle | Yan-ping Xu Zheng Chen Robert M. Dorazio Guan-nan Bai Li-zhong Du Li-ping Shi Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China Scientific Reports |
| title | Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China |
| title_full | Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China |
| title_fullStr | Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China |
| title_full_unstemmed | Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China |
| title_short | Risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four: a multi-center, prospective, longitudinal cohort study in China |
| title_sort | risk factors for bronchopulmonary dysplasia infants with respiratory score greater than four a multi center prospective longitudinal cohort study in china |
| url | https://doi.org/10.1038/s41598-023-45216-x |
| work_keys_str_mv | AT yanpingxu riskfactorsforbronchopulmonarydysplasiainfantswithrespiratoryscoregreaterthanfouramulticenterprospectivelongitudinalcohortstudyinchina AT zhengchen riskfactorsforbronchopulmonarydysplasiainfantswithrespiratoryscoregreaterthanfouramulticenterprospectivelongitudinalcohortstudyinchina AT robertmdorazio riskfactorsforbronchopulmonarydysplasiainfantswithrespiratoryscoregreaterthanfouramulticenterprospectivelongitudinalcohortstudyinchina AT guannanbai riskfactorsforbronchopulmonarydysplasiainfantswithrespiratoryscoregreaterthanfouramulticenterprospectivelongitudinalcohortstudyinchina AT lizhongdu riskfactorsforbronchopulmonarydysplasiainfantswithrespiratoryscoregreaterthanfouramulticenterprospectivelongitudinalcohortstudyinchina AT lipingshi riskfactorsforbronchopulmonarydysplasiainfantswithrespiratoryscoregreaterthanfouramulticenterprospectivelongitudinalcohortstudyinchina |