Understanding the short and long-term pulmonary and neurologic outcomes of neonates with bronchopulmonary dysplasia (BPD) is important in neonatal care for low-birth-weight infants. Different criteria for BPD may have different associations with long-term outcomes. Currently, two criteria for diagnosing BPD have been proposed by the NIH (2001) and NRN (2019) for preterm infants at a postmenstrual age (PMA) of 36 weeks. We investigated which BPD definition best predicts long-term outcomes. Korean nationwide data for preterm infants born between 24 +0 and < 32 +0 weeks gestation from were collected. For long-term outcomes, severity based on the NRN criteria was significantly related to neurodevelopmental impairment (NDI) in a univariate analysis after other risk factors were controlled. For the admission rate for respiratory disorder, grade 3 BPD of the NRN criteria had the highest specificity (96%), negative predictive value (86%), and accuracy (83%). For predicting NDI at the 18–24 month follow-up, grade 3 BPD of the NRN criteria had the best specificity (98%), positive (64%) and negative (79%) predictive values, and accuracy (78%) while NIH severe BPD had the highest sensitivity (60%). The NRN definition was more strongly associated with poor 2-year developmental outcomes. BPD diagnosed by NRN definitions might better identify infants at high risk for NDI.
Addition
Bronchopulmonary dysplasia (BPD) was a primary effect in the suprisingly low birth pounds infants (VLBWIs). More serious BPD is actually on the a heightened probability of developmental impairment and less pulmonary setting step one,dos,step 3 . The medical span of the disease, including the significance of rehospitalization and you will neurodevelopmental disability, is actually a recorded concern certainly parents and you can health care team cuatro . Understanding how situation severity is associated with the developmental decelerate and you can readmissions will help guide upcoming lookup and you can top quality update efforts to reduce the burden of the issues.
BPD was laid out from the Northway et al. 5 more than 50 years back; not, during the 2001, this new National Institute from Kid Fitness (NIH) changed the categorical meanings out-of BPD. Recently, inter-cardiovascular system variability in fresh air government and nose cannula circulate, in addition to the entry to noninvasive ventilation, can also be prejudice brand new NIH category of BPD exposure and you will severity. Put simply, this type of widely used standards might not be appropriate for the current medical disease and/or prediction out of a lot of time-name negative effects of latest VLBWIs 6,seven . According to this difference, Jensen mais aussi al. 8 advised another type of definition of BPD you to better predict very early youth morbidity and you can classified state seriousness according to mode of respiratory help, regardless of the use of extra clean air. It meaning try changed to way more accurately assume respiratory readmission and you can developmental delays from inside the an effective U.S.-created populace.
Which, i aligned to determine and therefore concept of BPD in the an effective PMA regarding thirty six months is actually most appropriate having predicting long-name neonatal effects, for example pulmonary and neurological effects, mentioned within 18–couple of years corrected ages (CA), when you look at the an effective multicenter cohort examination of VLBWIs according to the all over the country Korean Neonatal Network (KNN) registry.
Overall performance
A total of 8294 babies produced ranging from twenty four +0 days and you can 31 +6 weeks GA was indeed inserted towards KNN, Shortly after leaving out kids, 2889 VLBWIs stayed; included in this, 1849 (64.0%) silversingles had complete pursue-right up information offered at Ca 18–a couple of years, also respiratory readmission and you can developmental effects (Fig. 1). Of them 1849 VLBWIs, 1221 (66.0%) got BPD depending on the NIH definition, including 665 babies (36%) with light BPD, 184 babies (10%) which have modest BPD, and you may 372 infants (19%) having big BPD. Conversely 555 kids (30%) got BPD depending on the NRN definition, plus 186 children (10%) with values step one BPD, 303 infants (16%) which have stages 2 BPD, and 66 kids (4%) having level step three BPD (Dining table step 1).