TY - JOUR
T1 - Differences in Comorbidities and Clinical Burden of Severe Bronchopulmonary Dysplasia Based on Disease Severity
AU - Kim, Hye Rim
AU - Jung, Young Hwa
AU - Kim, Beyong Il
AU - Kim, So Young
AU - Choi, Chang Won
N1 - Publisher Copyright:
© Copyright © 2021 Kim, Jung, Kim, Kim and Choi.
PY - 2021/7/2
Y1 - 2021/7/2
N2 - Background: The present study compared baseline characteristics, comorbidities and clinical burden of pre-term infants with type 1 and 2 severe bronchopulmonary dysplasia (BPD) Collaborative classification. Methods: This study was a prospective cohort study of pre-term (<32 weeks) very-low-birth-weight infants. Severe BPD was divided into type 1 severe BPD requiring of ≥30% oxygen and/or non-invasive ventilation at 36 weeks post-menstrual age (PMA), and type 2 severe BPD requiring invasive mechanical ventilation at 36 weeks PMA. Baseline characteristics, comorbidities, and clinical burden were compared between these two types of severe BPD. Results: Of the 1,328 infants included, 983 (74.0%) developed type 1 severe BPD, and 345 (26.0%) developed type 2 severe BPD. Lower birth weight, small for gestational age, lesser maternal pre-mature rupture of membrane, lower 5-min Apgar score, air leak, pulmonary hemorrhage, surgical ligation of patent ductus arteriosus, necrotizing enterocolitis, and late-onset sepsis were significantly associated with type 2 severe BPD. Compared with infants with type 1 severe BPD, infants with type 2 severe BPD had an increased risk of mortality (aOR 18.64, 95% CI 10.81–32.13), pulmonary hypertension (aOR 2.16, 95% CI 1.59–2.93), and tracheostomy (aOR 10.38, 95% CI 2.05–52.49). Conclusions: Our data highlight the substantially greater mortality and clinical burden in infants with type 2 severe BPD than infants with type 1 severe BPD. A comprehensive and multidisciplinary approach is needed for infants with type 2 severe BPD.
AB - Background: The present study compared baseline characteristics, comorbidities and clinical burden of pre-term infants with type 1 and 2 severe bronchopulmonary dysplasia (BPD) Collaborative classification. Methods: This study was a prospective cohort study of pre-term (<32 weeks) very-low-birth-weight infants. Severe BPD was divided into type 1 severe BPD requiring of ≥30% oxygen and/or non-invasive ventilation at 36 weeks post-menstrual age (PMA), and type 2 severe BPD requiring invasive mechanical ventilation at 36 weeks PMA. Baseline characteristics, comorbidities, and clinical burden were compared between these two types of severe BPD. Results: Of the 1,328 infants included, 983 (74.0%) developed type 1 severe BPD, and 345 (26.0%) developed type 2 severe BPD. Lower birth weight, small for gestational age, lesser maternal pre-mature rupture of membrane, lower 5-min Apgar score, air leak, pulmonary hemorrhage, surgical ligation of patent ductus arteriosus, necrotizing enterocolitis, and late-onset sepsis were significantly associated with type 2 severe BPD. Compared with infants with type 1 severe BPD, infants with type 2 severe BPD had an increased risk of mortality (aOR 18.64, 95% CI 10.81–32.13), pulmonary hypertension (aOR 2.16, 95% CI 1.59–2.93), and tracheostomy (aOR 10.38, 95% CI 2.05–52.49). Conclusions: Our data highlight the substantially greater mortality and clinical burden in infants with type 2 severe BPD than infants with type 1 severe BPD. A comprehensive and multidisciplinary approach is needed for infants with type 2 severe BPD.
KW - comorbidities of pre-maturity
KW - neonatology
KW - pre-term infants
KW - severe bronchopulmonary dysplasia
KW - very low birth weight
UR - http://www.scopus.com/inward/record.url?scp=85110783163&partnerID=8YFLogxK
U2 - 10.3389/fped.2021.664033
DO - 10.3389/fped.2021.664033
M3 - Article
AN - SCOPUS:85110783163
VL - 9
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
SN - 2296-2360
M1 - 664033
ER -