Life-threatening bronchopulmonary dysplasia: a British Paediatric Surveillance Unit Study.
Bronchopulmonary Dysplasia
/ complications
Ductus Arteriosus, Patent
/ complications
Female
Gestational Age
Glucocorticoids
/ therapeutic use
Humans
Hypertension, Pulmonary
/ complications
Incidence
Infant, Newborn
Infections
/ complications
Ireland
/ epidemiology
Male
Population Surveillance
Positive-Pressure Respiration
Prospective Studies
Treatment Outcome
United Kingdom
/ epidemiology
Vasodilator Agents
/ therapeutic use
epidemiology
neonatology
Journal
Archives of disease in childhood. Fetal and neonatal edition
ISSN: 1468-2052
Titre abrégé: Arch Dis Child Fetal Neonatal Ed
Pays: England
ID NLM: 9501297
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
08
03
2021
accepted:
25
05
2021
pubmed:
30
6
2021
medline:
4
1
2022
entrez:
29
6
2021
Statut:
ppublish
Résumé
To assess the minimum incidence of life-threatening bronchopulmonary dysplasia (BPD), defined as need for positive pressure respiratory support or pulmonary vasodilators at 38 weeks corrected gestational age (CGA), in infants born <32 weeks gestation in the UK and Ireland; and to describe patient characteristics, management and outcomes to 1 year. Prospective national surveillance study performed via the British Paediatric Surveillance Unit from June 2017 to July 2018. Data were collected in a series of three questionnaires from notification to 1 year of age. 153 notifications met the case definition, giving a minimum incidence of 13.9 (95% CI: 11.8 to 16.3) per 1000 live births <32 weeks' gestation. Median gestation was 26.1 (IQR 24.6-28) weeks, and birth weight 730 g (IQR 620-910 g). More affected infants were male (95 of 153, 62%; p<0.05). Detailed management and outcome data were provided for 94 infants. Fifteen died at median age 159 days (IQR 105-182) or 49.6 weeks CGA (IQR 43-53). Median age last receiving invasive ventilation was 50 days (IQR 22-98) and total duration of pressure support for surviving infants 103 (IQR 87-134) days. Fifty-seven (60.6%) received postnatal steroids and 22 (23.4%) pulmonary vasodilators. Death (16%) and/or major neurodevelopmental impairment (37.3%) or long-term ventilation (23.4%) were significantly associated with need for invasive ventilation near term and pulmonary hypertension. This definition of life-threatening BPD identified an extremely high-risk subgroup, associated with serious morbidity and mortality. Wide variability in management was demonstrated, and future prospective study, particularly in key areas of postnatal steroid use and pulmonary hypertension management, is required.
Identifiants
pubmed: 34183433
pii: archdischild-2021-322001
doi: 10.1136/archdischild-2021-322001
pmc: PMC8685630
doi:
Substances chimiques
Glucocorticoids
0
Vasodilator Agents
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
13-19Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Cochrane Database Syst Rev. 2017 Aug 24;8:CD002311
pubmed: 28836266
Am J Respir Crit Care Med. 2015 Jul 15;192(2):134-56
pubmed: 26038806
J Pediatr. 2014 Dec;165(6):1258-60
pubmed: 25217197
BMJ Paediatr Open. 2018 Jan 9;2(1):e000165
pubmed: 29637181
Cochrane Database Syst Rev. 2016 Jun 14;(6):CD001243
pubmed: 27315509
Am J Respir Crit Care Med. 2001 Jun;163(7):1723-9
pubmed: 11401896
Neonatology. 2014;106(4):337-47
pubmed: 25278176
Cochrane Database Syst Rev. 2011 Sep 07;(9):CD001453
pubmed: 21901676
Arch Dis Child Fetal Neonatal Ed. 2020 May;105(3):232-239
pubmed: 31980443
Arch Dis Child Fetal Neonatal Ed. 2018 May;103(3):F285-F291
pubmed: 29363502
Cochrane Database Syst Rev. 2011 Sep 07;(9):CD001817
pubmed: 21901679
Eur Respir J. 2020 Jan 2;55(1):
pubmed: 31558663
Arch Dis Child Fetal Neonatal Ed. 2021 Jan;106(1):45-50
pubmed: 32571832
Cochrane Database Syst Rev. 2017 Oct 24;10:CD001145
pubmed: 29063594
BMJ. 2012 Dec 04;345:e7961
pubmed: 23212880
JAMA Pediatr. 2017 Mar 1;171(3):271-279
pubmed: 28114678
Am J Respir Crit Care Med. 2019 Sep 15;200(6):751-759
pubmed: 30995069
Paediatr Perinat Epidemiol. 2018 May;32(3):258-267
pubmed: 29341209
Pediatr Pulmonol. 2019 Feb;54(2):165-170
pubmed: 30537393
Neonatology. 2016;110(3):204-9
pubmed: 27220537
Children (Basel). 2020 Aug 15;7(8):
pubmed: 32824244
Cochrane Database Syst Rev. 2016 Dec 14;12:CD003214
pubmed: 27960245
Lancet Child Adolesc Health. 2019 Dec;3(12):842-844
pubmed: 31585808
BMJ Paediatr Open. 2021 Feb 22;5(1):e000897
pubmed: 33705500
J Pediatr. 2016 Jun;173:50-55.e1
pubmed: 27004673
Pediatr Pulmonol. 2017 Jan;52(1):77-83
pubmed: 27333438
J Paediatr Child Health. 2017 Dec;53(12):1215-1219
pubmed: 28661028
JAMA. 2015 Sep 8;314(10):1039-51
pubmed: 26348753