Abstract:

Objective To investigate the main risk factors and long term outcome of preterm infants with bronchopulmonary dysplasia (BPD). Methods Children with BPD were collected from neonatal intensive care units (NICU) in Children′s Hospital Fudan University, from January 1, 2012 to December 31, 2013. All babies with gestational age ≤ 32 weeks, birth weight ≤1 500 g, and admission within 7 days after birth were included in this study. In the same period，according to the inclusion criteria, the same sample size of non BPD was collected as control group. Univariate and multiple logistic regression analyses were used to determine factors associated with the risk of BPD. At the same time ,the incidence of bronchitis,pneumonia,wheezing and rehospitalization were analyzed during the first two years of life. Results There were 156 cases in BPD group and matched 156 infants without BPD in control group. Mother′s information including age, the proportion of preeclampsia and vaginal delivery was significantly higher in BPD group than that in control group(P=0.046,0.025 and <0.001). Birth gestational age and birth weight of BPD group were significantly lower than those of control grouop ( P <0.001 ).Infant information including 1 min Apgar score, 5 min Apgar score, sepsis ≥72 h , patent ductus arteriosus ( PDA ), retinopathy of prematurity ( ROP ) , ventilator associated pneumonia ( VAP ) , the application of PS and mechanical ventilation ≥7 d was significantly higher in BPD group than that in control group. The factors increasing the risk of BPD determined by multivariate logistic analysis were: gestational age (OR=0.46，95%CI:0.37-0.58), mechanical ventilation ≥7 d(OR= 9.47，95%CI:3.70-24.27), PDA (OR= 2.21，95%CI:1.18-4.12 ) and preeclampsia( OR= 4.91，95%CI:1.26-19.15). In the first year of life, the incidence of bronchitis and wheezing in preterm-born children with a history of BPD was significantly higher than that in preterm-born children without BPD, but there was no significant difference in rehospitalization between the two groups. The incidence of pneumonia of BPD group was significantly decreased in the second year of life, while there was no significant difference in bronchitis, wheezing and rehospitalization compared to the first year of life. Conclusion Low gestational age, mechanical ventilation ≥7 d, patent ductus arteriosus, preeclampsia were highest risk factors for BPD. Among premature infants, BPD substantially increased the risk of lower respiratory tract infection during the first year of life.