Original ArticleTrends in severe bronchopulmonary dysplasia rates between 1994 and 2002
Section snippets
Study Population
The infants were cared for in the 6 level III neonatal intensive care units (NICUs) in the Northern California Kaiser Permanente Medical Care Program (KPMCP) between 1994 and 2002. All infants were admitted alive to the NICU with a gestational age (GA) <33 weeks. Infants with major congenital malformations were excluded from the study.
Data were obtained from the KPMCP Neonatal Minimum Data Set (NMDS) by using previously described methods.14, 15, 16 The NMDS database captures >95% of level III
Study Sample
Of the 5115 infants studied, 603 (12%) had BPD, including 246 (4.9%) who had severe BPD. There were 481 deaths (9.5%) before 36 weeks corrected GA. Table I shows that of the infants with BPD, infants with severe BPD were more likely to be male, have lower birth weights, have longer NICU stays, and have more medical complications.
Trends in BPD
The trends in BPD, severe BPD, and death before 36 weeks corrected GA were similar in subgroups of the study population defined by race, sex, or SGA status. We
Discussion
In this population of premature infants born between 1994 and 2002, although the overall rate of BPD remained constant, the GA-adjusted odds of having severe BPD declined on average 11% per year (P <.0001). In uncontrolled analysis, most of the decline occurred between 1994 and 1998. The odds of an infant dying before 36 weeks corrected GA during this same period also declined 5.6% per year (P = .03). These data are consistent with and extend those from earlier reports.8 The rate of decline of
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Cited by (133)
Mortality in Outpatients with Bronchopulmonary Dysplasia
2022, Journal of PediatricsCitation Excerpt :Although other studies have similarly demonstrated an increased risk of mortality in infants with a diagnosis of BPD compared with those with no lung disease,8 we were unable to draw any conclusions about the relationship between the severity of disease and risk of mortality. Additionally, we did not observe any association between mortality and low birth weight, as has been reported in several prior studies10,11,19; this may be related to our population having a mean birth weight of <1000 g and a higher risk of comorbidities, as the study population was limited to those infants with BPD. Older age at the time of discharge was associated with an increased risk of mortality, which suggests that infants with more prenatal and perinatal complications, requiring more interventions and subsequent longer hospitalization, are at continued risk of mortality following discharge and require close monitoring.
Black Race Is Associated with a Lower Risk of Bronchopulmonary Dysplasia
2019, Journal of PediatricsRecent advances in the pathogenesis of BPD
2018, Seminars in PerinatologyCitation Excerpt :BPD continues to be one of the most common complications of preterm birth encountered in a neonatal intensive care setting.2 Trends in the incidence of BPD are currently a matter of discussion, where improved survival of extremely preterm infants has been proposed to underlie increasing rates of BPD,3,4 whilst other studies report unchanged or reduced incidence of BPD.5–7 However, what is clear is that the spectrum of the affected population of infants has shifted, where the incidence of BPD is now lower in infants delivered at >28 weeks, whilst the incidence of BPD has increased in infants born at <28 weeks.8–11
Surfactant, steroids and non-invasive ventilation in the prevention of BPD
2018, Seminars in PerinatologyCitation Excerpt :The adverse effects of BPD extend well into childhood and adulthood with associated significant health care costs.2 Even though there is currently a better understanding of the pathogenesis of BPD, its incidence has remained somewhat constant because of the increased survival of extreme preterm infants.3,4 These infants are born at the late canalicular–saccular stage of lung development with resulting surfactant inadequacy.
Lung function trajectories throughout childhood in survivors of very preterm birth: a longitudinal cohort study
2018, The Lancet Child and Adolescent HealthLong-term pulmonary outcomes of young adults born prematurely: a Polish prospective cohort study PREMATURITAS 20
2024, BMC Pulmonary Medicine
Supported by a National Research Service Award institutional training grant (AHRQ T32 HS 000063) to the Harvard Pediatric Health Services Research Fellowship Program and a Harvard School of Public Health Department of Maternal Child Health Educational training grant (MCHP 2T 76MC 00001-47).
Presented in abstract and poster form at the Pediatric Academic Societies' Annual Meeting in Baltimore, Maryland, May 4-7, 2002; presented in poster form at the New England Perinatal Society Meeting in Manchester Village, Vermont, March 1-3, 2002.