Risk factors for the development of bronchopulmonary dysplasia: a case-control study

Abstract

DOI: 10.1016/j.rcpe.2016.03.001

Introduction

The development of ventilator support is one of the main factors contributing to the survival of premature infants. However, this has led to lung injury and an increase in the incidence of bronchopulmonary dysplasia.

Methodology

In order to determine risk factors for the development of bronchopulmonary dysplasia in preterm infants, a cases and controls study was designed that included 36 infants with bronchopulmonary dysplasia and compared with 108 controls. A logistic regression model was created to evaluate the effect on the risk of bronchopulmonary dysplasia.

Results

In univariate analysis, the factors associated with bronchopulmonary dysplasia were: FiO2>35% for more than 3 days, hyaline membrane disease, early sepsis, pneumothorax/pulmonary interstitial emphysema, patent ductus arteriosus, 4 or more red blood cell transfusions, and pregnancy induced hypertension. The predictors for the development of bronchopulmonary dysplasia in preterm infants less than 34 weeks were identified using binary logistic regression analysis. These were found to be: pneumothorax or pulmonary interstitial emphysema (odds ratio, OR=1.7; 95% CI; 1.3-9.1; p=.039), and 4 or more red blood cell transfusions (OR=2.1; 95% CI; 1.6-8.1; p=.025). Mortality was higher in the group with bronchopulmonary dysplasia (41.7% vs. 22.2%, p=.023).

Conclusion

Pneumothorax or pulmonary interstitial emphysema, and 4 or more red blood cell transfusions are reliable tools to predict development of bronchopulmonary dysplasia in preterm infants less than 34 weeks. Early diagnosis, corrected air leak syndrome, optimising indications for transfusion, as well as, improving the mechanical ventilatory support may decrease mortality and frequency of bronchopulmonary dysplasia in this patient group.