Pulmonary function and bronchopulmonary dysplasia classification: insights from the Spanish Registry

In 2016, the Spanish Research Group on Bronchopulmonary Dysplasia (BPD) (GEIDIS) established a national registry with participation of 66 hospitals to collect information on clinical characteristics and long-term outcomes of BPD infants into adulthood. The aim of this observational study is to exami...

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Published in:	European journal of pediatrics Vol. 183; no. 9; pp. 3757 - 3766
Main Authors:	Ramos-Navarro, Cristina, Pérez-Tarazona, Santiago, Sanz-López, Ester, Rueda-Esteban, Santiago, Taboada Perianes, María, Gonzalez Torres, Lucía, Sirvent Gómez, Josep, García Cantó, Eva, Moral Gil, Luis, Escudero, Carmen, Baquero Cano, Maria, Alfonso Diego, Julia, Mesa Vázquez, Juan, Castillo, Fátima, Armendáriz, Laura, Costa Colomer, Jordi, Ferrer, Margarita, Santiago, Mikel, Rodeño Fernández, Lorena, Villar Alvárez, Mª Ángeles, Aguerrea Menendez, Margarita, Gutiérrez Amorós, Ana, Zabala Gonzalez, Iranzu, Meseguer, Nerea Bilbao, Zabala Cendoya, María, Díez Sáez, Carmen, Rodriguez Cano, Nerea, Schuffelmann Gutierrez, Susana, Barrio Sacristán, Ana Raquel, Méndez Abad, Paula, Leante Castellanos, Jose Luis, Marin Cassinello, Carmen, Martinez Olmos, Javier, Diaz García, Carolina, Ferrer Vázquez, Mario, Escorihuela Centelles, Ana, Cubells Serra, Inmaculada, Lopez Menchero Oliva, Jesus Cecilio, Torres Borrego, Javier, Canals Candela, Francisco, Aragón Fernández, Carmen, Díaz Colom, Maria Cruz, Martinez Colmenero, Carmen, Martinez Pardo, Luz María, Hernandez García, Elisenda, Navarro Dourdil, Ana, Morillo, Pablo, Sanchéz-Torres, Ana María, Esteban, Santiago Rueda, Arruza Gómez, Luis, Romero Otero, Alfonso, Bautista Lozano, Diego, Ruiz Jimenez, Marta, Arroyas Sánchez, María, García García, Mª Luz, Ramos Navarro, Cristina, Maderuelo Rodriguez, Elena, Sanz López, Ester, Rodríguez, Mª Salomé Albi, de Atauri, Alvaro Gimeno, Sánchez Mateos, Miguel, del Mar Serrano Martín, María, Caro Aguilera, Pilar, López, Reyes Roldán, Pradillo Martín, María Cristina, Mantecón Fernández, Laura, Crespo Suarez, Pilar, Sánchez, Natividad Viguria, Urriza, Ilargi, Sierra Colomina, Gema, Ayats, Roser, Figaró, Carme, Barajas, Visitación, Remesal Escalero, Ana, Roux, Ana, Pérez Baena, Luis, Bardallo Cruzado, Leonor, Andrés, Anselmo, Delgado Pecellín, Isabel, Gaboli, Mirella, Pavón Delgado, Antonio, García García, Elisa, Carrión Castellet, Francisco, Vázquez Rodríguez, Elena, Papaleu, Andrea, Vásquez, Amalui, Monterde Álvarez, Laura, Navarro Carmona, María Jesús, Sánchez-Redondo Sánchez-Gabriel, Mª Dolores, Molina Merino, Agustín, Capell, Javier Estañ, Macián, Eva Flor, Pérez Tarazona, Santiago, Montejo Vicente, Mar, Urueña, Sara Isabel Marín, Concheiro, Ana, Muga Zuriarrain, Ohiana, Corcuera Elosegui, Paula, del Hoyo Moracho, Marta, Rite Gracia, Segundo
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2024 Springer Nature B.V
Subjects:	Age Children Classification Dysplasia Gestational age Infants Long-term effects Lung diseases Mechanical ventilation Medicine Medicine & Public Health Oxygen Patients Pediatrics Respiratory function Spirometry Statistical analysis
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Summary:	In 2016, the Spanish Research Group on Bronchopulmonary Dysplasia (BPD) (GEIDIS) established a national registry with participation of 66 hospitals to collect information on clinical characteristics and long-term outcomes of BPD infants into adulthood. The aim of this observational study is to examine forced spirometry data in early childhood and to assess their correlation with the respiratory support required at 36 weeks postmenstrual age (PMA). The study analyzed data from preterm infants with BPD born between January 2016 and December 2017 who underwent forced spirometry at 5–7 years of age. Statistical analyses were conducted to investigate the relationships between spirometry results, perinatal factors, and the required respiratory support at 36 weeks PMA. The study involved 143 patients with a median gestational age (GA) of 27.3 weeks (range 25.7–28.7) and a median weight of 880 g (range 740–1135). Abnormal spirometry results were observed in 39.2% (56) of the patients. Among patients diagnosed with BPD type 3, those requiring over 30% oxygen at 36 weeks PMA exhibited an increased risk of abnormal spirometry results (OR 4.48; 95% CI 1.11–18.13) compared to those requiring positive pressure with less than 30% oxygen. In addition, this subgroup had a higher risk of developing a restrictive-mixed pattern compared to those with BPD type 1 (OR 10.65; 95% CI 2.06–54.98) and BPD type 2 (OR 6.76; 95% CI 1.09–42.06). No significant differences were found in the incidence of an obstructive pattern between BPD types. Conclusion : The requirement of more than 30% oxygen at 36 weeks PMA serves as a risk indicator for pulmonary function impairment in school-aged children with BPD. These findings suggest persistent airway and parenchymal injury in this specific patient population, and highlight the importance of careful monitoring to evaluate their long-term effects on lung function. What is Known: • Premature patients with bronchopulmonary dysplasia (BPD) may present abnormalities in pulmonary function tests during school age. However, the predictive accuracy of consensus BPD severity classification remains uncertain. What is New: • The requirement of more than 30% oxygen at 36 weeks postmenstrual age (PMA) indicates a potential risk of pulmonary function impairment in school-aged children with BPD. Additionally, a significant correlation has been observed between a restrictive-mixed pattern with exposure to mechanical ventilation and the development of severe forms of BPD.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1432-1076 0340-6199 1432-1076
DOI:	10.1007/s00431-024-05629-w