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Original research
Bronchopulmonary dysplasia: temporal trend from 2010 to 2019 in the Brazilian Network on Neonatal Research
  1. Camila Stolz1,
  2. Daniela Testoni Costa-Nobre1,
  3. Adriana Sanudo1,
  4. Daniela Marques de Lima Mota Ferreira2,
  5. José Mariano Sales Alves Jr3,
  6. Julia Paula dos Santos4,
  7. Milton Harumi Miyoshi1,5,
  8. Nathalia Moura de Mello Silva6,
  9. Fernanda Pegoraro de Godoi Melo7,
  10. Regina Vieira Cavalcanti da Silva8,
  11. Dafne Barcala9,
  12. Marynea Silva Vale10,
  13. Ligia Maria Suppo de Souza Rugolo11,
  14. Edna Maria Albuquerque Diniz12,
  15. Manoel Ribeiro13,
  16. Sérgio T M Marba14,
  17. Silvia Cwajg15,
  18. José Luiz Muniz Bandeira Duarte16,
  19. Walusa Assad Gonçalves Ferri17,
  20. Renato S Procianoy18,
  21. Leni Marcia Anchieta19,
  22. José Maria de Andrade Lopes15,
  23. Maria Fernanda B de Almeida1,
  24. Ruth Guinsburg1
  1. 1 Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
  2. 2 Universidade Federal de Uberlândia, Uberlândia, Brazil
  3. 3 Faculdade de Ciencias Medicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  4. 4 Hospital Estadual de Sumaré, Sumaré, São Paulo, Brazil
  5. 5 Hospital Geral de Pirajussara, Taboão da Serra, São Paulo, Brazil
  6. 6 Hospital Estadual de Diadema, Diadema, São Paulo, Brazil
  7. 7 Universidade Estadual de Londrina, Londrina, Paraná, Brazil
  8. 8 Universidade Federal do Paraná, Curitiba, Paraná, Brazil
  9. 9 Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil
  10. 10 Universidade Federal do Maranhão, Sao Luiz, Maranhão, Brazil
  11. 11 Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
  12. 12 Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
  13. 13 Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
  14. 14 Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
  15. 15 Instituto Nacional de Saúde da Mulher da Criança e do Adolescente Fernandes Figueira, Rio de Janeiro, Brazil
  16. 16 Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
  17. 17 Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, São Paulo, Brazil
  18. 18 Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
  19. 19 Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  1. Correspondence to Professor Daniela Testoni Costa-Nobre, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil; danielatestoni{at}gmail.com

Abstract

Objective To evaluate the temporal trend of bronchopulmonary dysplasia (BPD) in preterm infants who survived to at least 36 weeks’ post-menstrual age (PMA) and BPD or death at 36 weeks’ PMA, and to analyse variables associated with both outcomes.

Design Retrospective cohort with data retrieved from an ongoing national registry.

Setting 19 Brazilian university public hospitals.

Patients Infants born between 2010 and 2019 with 23–31 weeks and birth weight 400–1499 g.

Main outcome measures Temporal trend was evaluated by Prais-Winsten model and variables associated with BPD in survivors or BPD or death were analysed by logistic regression.

Results Of the 11 128 included infants, BPD in survivors occurred in 22%, being constant over time (annual per cent change (APC): −0.80%; 95% CI: −2.59%; 1.03%) and BPD or death in 45%, decreasing over time (APC: −1.05%; 95% CI: −1.67%; −0.43%). Being male, small for gestational age, presenting with respiratory distress syndrome, air leaks, needing longer duration of mechanical ventilation, presenting with treated patent ductus arteriosus and late-onset sepsis were associated with an increase in the chance of BPD. For the outcome BPD or death, maternal bleeding, multiple gestation, 5-minute Apgar <7, late-onset sepsis, necrotising enterocolitis and intraventricular haemorrhage were added to the variables reported above as increasing the chance of the outcome.

Conclusion The frequency of BPD in survivors was constant and BPD or death decreased by 1.05% at each study year. These results show some improvement in perinatal care in Brazilian units which resulted in a reduction of BPD or death, but further improvements are still needed to reduce BPD in survivors.

  • Neonatology
  • Respiratory Medicine
  • Mortality
  • Intensive Care Units, Neonatal
  • Child Health

Data availability statement

Data are available upon reasonable request. Data used for this manuscript are from an ongoing national registry. Data are available upon reasonable request.

https://doi.org/10.1136/archdischild-2023-325826

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    Data availability statement

    Data are available upon reasonable request. Data used for this manuscript are from an ongoing national registry. Data are available upon reasonable request.

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    Footnotes

    • Contributors DTC-N is guarantor, designed the study, had access to the data. CS and RG designed the study, analysed the data. All other authors collected the data, reviewed the analysis and reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.