Neonatal Med.  2020 Feb;27(1):1-7. 10.5385/nm.2020.27.1.1.

Changes in the Incidence of Bronchopulmonary Dysplasia among Preterm Infants in a Single Center over 10 Years

• Jeon GW

• KMID: 2502086
• DOI: http://doi.org/10.5385/nm.2020.27.1.1

Abstract

Purpose
Bronchopulmonary dysplasia (BPD) is one of the most fatal respiratory morbidities in preterm infants, causing adverse respiratory and neurodevelopmental outcomes. Despite advances in neonatal ventilator care, the incidence of BPD has been static or even increased. The purpose of this study was to evaluate the incidence of BPD in a single center over 10 years.

Methods
Preterm infants with gestational age (GA) <30 weeks who were admitted to Inje University Busan Paik Hospital from January 2009 to December 2018 and sur vived 28 days or more were enrolled. The incidence of BPD according to year and GA and the risk factors of BPD were evaluated.

Results
Among 629 infants, 521 infants who survived 28 days or more were enrolled (BPD group, n=252; non-BPD group, n=269). The incidence of BPD was 48.4%, with moderate to severe BPD accounting for 13.9%. In preterm infants with GA ≤25, 26 to 27, and 28 to 29 weeks, the incidences of BPD were 57.5%, 51.5%, and 14.6%, respectively, with moderate to severe BPD accounting for 23.8%, 10.5%, and 3.7%, respectively. The incidence of BPD decreased from 68% in 2009 to 34.3% in 2014. Subsequently, it increased. Surfactant re-dosing and patent ductus arteriosus were more frequent in the BPD group than in the non-BPD group.

Conclusion
BPD did not decrease over the previous 10 years despite advances in neonatal care.

Keyword

Bronchopulmonary dysplasia; Infant, premature; Infant, very low birth weight; Infant, extremely low birth weight; Infant, extremely premature

Figure

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  Figure 1. Incidence of bronchopulmonary dysplasia (BPD) according to year. The incidence of BPD decreased from 68% in 2009 to 34.3% in 2014 (P=0.001), and then increased. From 2012 to 2014, BPD incidence decreased and the mortality rate of preterm infants with gestational age (GA) ≤25 weeks increased. From 2016 to 2017, the incidence of BPD increased and mortality, especially preterm infants with GA ≤25 weeks, decreased. Moderate to severe the incidence of BPD decreased in 2014 (7.8%) and increased in 2016 (25%).

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  Figure 2. Incidence of bronchopulmonary dysplasia (BPD) according to gestational age (GA). Mortality and incidence of BPD, especially moderate to severe BPD, decreased as GA increased. The mortality rate was 38.1% in those with GA ≤25 weeks, 15.8% in those with GA 26 to 27 weeks, and 5.3% in those with GA 28 to 29 weeks (P<0.001). In those with GA ≤25, 26 to 27, and 28 to 29 weeks, the incidences of BPD were 57.5%, 51.5%, and 14.6%, respectively (P<0.001). The corresponding incidences of moderate to severe BPD were 23.8%, 10.5%, and 3.7%, respectively (P<0.001). Survival without BPD increased from 4.4% in GA ≤25 weeks to 33.7% in GA 26 to 27 weeks and then 80.1% in GA 28 to 29 weeks (P<0.001).

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