Impact of concept of bronchopulmonary dysplasia toward neurodevelopmental effects

Impact of concept of bronchopulmonary dysplasia toward neurodevelopmental effects

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 talkwithstranger profile 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.


Bronchopulmonary dysplasia (BPD) are a major risk from inside the really low beginning pounds children (VLBWIs). More severe BPD was on the an elevated likelihood of developmental impairment and you can less pulmonary form 1,dos,3 . The medical course of the disease, including the importance of rehospitalization and you may neurodevelopmental disability, was a recorded concern certainly parents and you will medical care business cuatro . Finding out how condition severity are from the developmental impede and you can readmissions may help guide coming look and you will high quality update initiatives to attenuate the responsibility on the disease.

BPD was discussed because of the Northway et al. 5 over 50 years ago; but not, inside the 2001, the brand new Federal Institute out of Kid Health (NIH) changed brand new categorical significance away from BPD. Recently, inter-heart variability when you look at the outdoors administration and nose cannula circulate, also the use of noninvasive ventilation, is also bias new NIH classification away from BPD presence and you may severity. This basically means, these types of widely used requirements is almost certainly not appropriate for the current clinical problem or perhaps the forecast regarding a lot of time-identity negative effects of modern VLBWIs six,7 . Relative to so it discrepancy, Jensen et al. 8 proposed another concept of BPD one to better forecast very early childhood morbidity and you can categorized disease seriousness according to the form off breathing help, long lasting use of extra fresh air. It definition try changed to even more correctly assume breathing readmission and you can developmental waits inside the a You.S.-created populace.

Which, we lined up to determine and that concept of BPD during the an effective PMA of 36 days try best suited for anticipating much time-title neonatal consequences, particularly pulmonary and you will neurologic effects, mentioned at 18–two years remedied decades (CA), in an effective multicenter cohort examination of VLBWIs according to the nationwide Korean Neonatal Network (KNN) registry.


A total of 8294 children created ranging from twenty-four +0 days and you will 29 +6 months GA was basically entered towards the KNN, Once excluding babies, 2889 VLBWIs remained; included in this, 1849 (64.0%) had done realize-right up pointers available at California 18–couple of years, and breathing readmission and you can developmental effects (Fig. 1). Ones 1849 VLBWIs, 1221 (66.0%) got BPD with respect to the NIH definition, as well as 665 babies (36%) with lightweight BPD, 184 babies (10%) having moderate BPD, and 372 babies (19%) which have serious BPD. On the other hand 555 children (30%) got BPD with regards to the NRN definition, including 186 kids (10%) that have level step 1 BPD, 303 infants (16%) having grade dos BPD, and you will 66 children (4%) with grade step 3 BPD (Dining table 1).

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