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.
Inclusion
Bronchopulmonary dysplasia (BPD) was a major side effect in suprisingly low birth weight babies (VLBWIs). More severe BPD try with the a heightened probability of developmental impairment and you will reduced pulmonary mode step one,2,step three . The course of the disease, such as the requirement for rehospitalization and you may neurodevelopmental disability, is actually a reported concern among moms and dads and you may medical care company cuatro . Understanding how situation severity is regarding the developmental reduce and you may readmissions can help book upcoming search and you will top quality improvement effort to attenuate the duty with the problems.
BPD was first laid out of the Northway mais aussi al. 5 over half a century ago; yet not, in the 2001, new Federal Institute of Man Health (NIH) changed the newest categorical significance regarding BPD. Now, inter-cardio variability into the fresh air administration and nasal cannula disperse, in addition to the entry to noninvasive venting, can also be bias this new NIH group regarding BPD exposure and you may seriousness. In other words, these types of popular standards may not be appropriate for the modern scientific problem or perhaps the forecast regarding much time-term aftereffects of modern VLBWIs six,seven . Prior to this difference, Jensen et al. 8 advised yet another definition of BPD one to ideal predicted very early childhood morbidity and you will classified situation severity with regards to the mode away from respiratory assistance, regardless of the accessibility extra oxygen. So it definition are changed so you can much more precisely assume breathing readmission and you may developmental delays during the a beneficial U.S.-created population.
And this, we aligned to determine hence concept of BPD on an excellent PMA away from 36 days was most suitable to possess anticipating a lot of time-name neonatal effects, such as pulmonary and you will neurologic effects, measured within 18–2 yrs fixed ages (CA), in good multicenter cohort examination of VLBWIs in accordance with the nationwide Korean Neonatal Circle (KNN) registry.
Efficiency
A total of 8294 children produced between 24 +0 days and you may 29 +6 months GA was inserted into the KNN, Immediately after leaving out kids, 2889 VLBWIs remained; among them, 1849 (64.0%) had over follow-right up information offered at California 18–2 yrs, and additionally respiratory readmission and you may developmental outcomes (Fig. 1). Of them 1849 VLBWIs, 1221 (66.0%) got BPD according to NIH meaning, along with 665 babies (36%) that have mild BPD, 184 babies (10%) that have modest BPD, and you will 372 babies (19%) that have significant BPD. In contrast 555 established men search infants (30%) got BPD according to the NRN definition, as well as 186 children (10%) that have levels 1 BPD, 303 infants (16%) that have degree dos BPD, and you will 66 babies (4%) which have values step three BPD (Desk 1).
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