Risk factors and bronchopulmonary dysplasia severity: data from the Spanish Bronchopulmonary Dysplasia Research Network

• Published in: European journal of pediatrics Vol. 181; no. 2; pp. 789 - 799
• Main Authors: Ramos-Navarro, Cristina, Concheiro-Guisán Ana, Sánchez-Torres, Ana, Sánchez-Solís, Manuel, Sanz-López Ester, del Mar Serrano Martín María, Sanz Ester, Maderuelo Elena, Muga, Zuriarrain Ohiana, Ferrer, Margarita, Santiago, Mikel, Guerra Eneritz, Amorós, Ana Gutiérrez, Villar, Maria Angeles, del Hoyo Moracho Marta, Lletget Wifredo Coroleu, del Mar Martínez Colls M, Gracia Segundo Rite, Martín, Vicente Carlos, Febles, Patricia, Borau María José García, Vásquez Amalui, Vaccarello Olalla Otero, Colomer Jordi Costa, Gómez Juan José Comuñas, Vernetta Alba Torrent, Escobar, Verónica Jimenez, Robles, Cascallar Pilar, Pérez, Susana Herrero, Ribera, Roser Porta, Jimenez, Miquel Ramon, Candel Francisco Canals, Alonso Debora Becerra, Ocón Amaya Pérez, Colomina Gemma Sierra, Valle, Eva García, Gutierrez, Rocio Sancho, Ramos, Victoria Ramos, Jaume Miquel Fiol, Bover Catalina, Baena, Luis Pérez, Medina Orlando Mesa, Tarazona Santiago Pérez, Aznar, Isidoro Cortell, Merino, Agustín Molina, Macián, Eva Flor, Corullón Silvia Castillo, Capell, Javier Estañ, Cano Maria Baquero, Gómez, Josep Sirvent, Taboada, Perianes María, Castañeda Montserrat Berrocal, Ríos, Alicia Sardina, Berrocal María Montserrat, Suarez, Pilar Crespo, González, Javier Vilas, Figaró Carme, Ayats Roser, Delgado Elena Hierro, Quintela Paula Alonso, Rodríguez, Marta Suárez, Temprano, Marianela Marcos, Urueña Sara Isabel Marín, Vicente Mar Montejo, Sáez Maria Jesús Rodríguez, Concheiro Ana, Reymundo Dra Mercedes García, Castellet Francisco José Carrión, Santos, Elisabeth Gómez, Ruiz, González M Dolores, Borrego, Javier Torres, Sacristán Ana Raquel Barrio, de la Cruz Ofelia Fernández, Padilla Mari Carmen Martínez, Marfil Victoria Esteban, Pérez, Guadalupe Pérez, Cruzado, Leonor Bardallo, Anselmo, Andrés, Otero, Alfonso Romero, Lopez Jesus Cecilio, Torres Ana María Sanchéz, Escalero, Ana Remesal, Sánchez Barajas, Dolores, Sánchez-Redondo M, Mosquera José Beceiro, Jimenez, Marta Ruiz, Luz García, García M, Moral, Gil Luis, Vázquez Ana Rosa Sánchez, Arenas Juan José Agüera, Solís, Manuel Sanchéz, Ametller Emma, Peñas Andreu, Muñoz, Manuel Gresa, Canino, Calderín Elisa, Verjano Felipe, Ocaña Sergio, Serrano, Ana Muñoz, Vázquez, Mario Ferrer, Jerez, Calero A
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2022; Springer Nature B.V
• Subjects: Adult; Age; Birth weight; Bronchopulmonary Dysplasia - epidemiology; Bronchopulmonary Dysplasia - etiology; Dysplasia; Female; Gestational Age; Hospitals; Humans; Infant; Infant, Newborn; Infant, Premature; Lung diseases; Male; Mechanical ventilation; Medicine; Medicine & Public Health; Morbidity; Original Article; Patients; Pediatrics; Pregnancy; Premature babies; Premature Birth; Prenatal experience; Risk Factors; Intrauterine growth restriction; Bronchopulmonary dysplasia; GEIDIS network; Oligohydramnios; Mechanical ventilation; Preterm infants
• DOI: 10.1007/s00431-021-04248-z
• EISSN: 1432-1076
• ISSN: 0340-6199

GEIDIS is a national-based research-net registry of patients with bronchopulmonary dysplasia (BPD) from public and private Spanish hospitals. It was created to provide data on the clinical characterization and follow-up of infants with BPD until adulthood. The purpose of this observational study was to analyze the characteristics and the impact of perinatal risk factors on BPD severity. The study included 1755 preterm patients diagnosed with BPD. Of the total sample, 90.6% (
n
 = 1591) were less than 30 weeks of gestation. The median gestational age was 27.1 weeks (25.8–28.5) and median birth weight 885 g (740–1,070 g). A total of 52.5% (
n
 = 922) were classified as mild (type 1), 25.3% (
n
 = 444) were moderate (type 2), and 22.2% (
n
 = 389) were severe BPD (type 3). In patients born at under 30 weeks’ gestation, most pre-and postnatal risk factors for type 2/3 BPD were associated with the length of exposure to mechanical ventilation (MV). Independent prenatal risk factors were male gender, oligohydramnios, and intrauterine growth restriction. Postnatal risk factors included the need for FiO
2
of > 0.30 in the delivery room, nosocomial pneumonia, and the length of exposure to MV.
Conclusion
: In this national-based research-net registry of BPD patients, the length of MV is the most important risk factor associated with type 2/3 BPD. Among type 3 BPD patients, those who required an FiO
2
 > .30 at 36 weeks’ postmenstrual age had a higher morbidity, during hospitalization and at discharge, compared to those with nasal positive pressure but FiO
2
 < .30.
What is Known:
• BPD is a highly complex multifactorial disease associated with preterm birth.
What is New:
• The length of exposure to mechanical ventilation is the most important postnatal risk factor associated to bronchopulmonary severity which modulate the effect of most pre and postnatal risk factors.
• Among patients with BPD, the requirement for FiO2 >.30% at 36 weeks of postmenstrual age is associated with greater morbidity during hospitalization and at discharge.