Atypical Chronic Lung Disease Patterns in Neonates

• Published in: Pediatrics (Evanston) Vol. 103; no. 4; pp. 759 - 765
• Main Authors: Charafeddine, Lama, D'Angio, Carl T, Phelps, Dale L
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL Am Acad Pediatrics 01-04-1999; American Academy of Pediatrics
• Subjects: Biological and medical sciences; Birth weight, Low; Bronchopulmonary dysplasia; Bronchopulmonary Dysplasia - epidemiology; Bronchopulmonary Dysplasia - therapy; Care and treatment; Chronic Disease; Cohort Studies; Complications and side effects; Female; Humans; Incidence; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - epidemiology; Infant, Premature, Diseases - therapy; Infant, Very Low Birth Weight; Infants (Premature); Intensive Care Units, Neonatal; Low birth weight; Lung diseases; Lung Diseases - epidemiology; Lung Diseases - therapy; Male; Medical diagnosis; Medical sciences; Pediatrics; Physiological aspects; Pneumology; Premature birth; Premature infants; Regression Analysis; Respiratory diseases; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; United States; Human; Premature; Lung disease; Respiratory disease; Definition; Clinical form; Wilson Mikity syndrome; Newborn diseases; Newborn; Prematurity; Pulmonary surfactant; Cohort study; Bronchus disease; Bronchopulmonary dysplasia; Atypical
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.103.4.759

To determine, in the postsurfactant era, the incidence and clinical characteristics of infants with atypical versus traditionally defined bronchopulmonary dysplasia (BPD) among premature infants with birth weights <1251 g.
Retrospective cohort study.
A single regional neonatal intensive care unit (level III/IV).
Two hundred thirty-two premature infants <1251 g at birth consecutively admitted during a 2-year period.
Incidence of classic BPD and atypical chronic lung disease (CLD) (occurring without preceding respiratory distress or after recovery from respiratory distress).
Among 177 infants <1251 g who survived to 28 days, 27 (15%) had atypical CLD and 61 (34.5%) had classic BPD. Atypical CLD infants were significantly heavier and more mature than classic BPD infants (mean birth weights, 922 +/- 152 g vs 854 +/- 173 g; and mean gestational age, 26.8 +/- 1.3 weeks vs 26.1 +/- 1.6 weeks). Median duration of ventilator support (31 days; range, 2 to 127 vs 42 days; range, 4-145 days) and oxygen therapy (30 days; range, 11 to 163 vs 48 days; range, 19-180 days) were shorter in atypical CLD infants than in classic BPD infants.
Atypical CLD comprised 31% of total cases of CLD. Atypical CLD appears to be less severe than classic BPD. These data suggest that initial, acute lung injuries are not the sole antecedents of neonatal CLD.