You are here

  • Home
  • Online First
  • Association between bronchopulmonary dysplasia severity and its risk factors and long-term outcomes in three definitions: a historical cohort study

Article Text

Article menu
Original research
Association between bronchopulmonary dysplasia severity and its risk factors and long-term outcomes in three definitions: a historical cohort study
  1. Trixie A Katz1,2,
  2. Anton H van Kaam2,3,
  3. Nicolaas P A Zuithoff4,
  4. S M Mugie5,6,
  5. Sabine Beuger7,
  6. Geert Jan Blok7,
  7. Anne A M W van Kempen8,
  8. Henriëtte van Laerhoven9,
  9. Claire A M Lutterman10,
  10. Maarten Rijpert11,
  11. Irene A Schiering12,
  12. Nicolien C Ran13,
  13. Fenna Visser14,
  14. Els van Straaten15,
  15. Cornelieke S H Aarnoudse-Moens16,
  16. Aleid G van Wassenaer-Leemhuis1,17,
  17. Wes Onland18
  1. 1 Neonatology, Emma Children's Hospital UMC, Amsterdam, The Netherlands
  2. 2 Amsterdam Reproduction and Development, Amsterdam, The Netherlands
  3. 3 Amsterdam University Medical Centers, Amsterdam, The Netherlands
  4. 4 University Medical Center Utrecht, Utrecht, The Netherlands
  5. 5 Department of Pediatrics, Tergooi Medical Center, Hilversum, The Netherlands
  6. 6 Emma Children's Hospital UMC, Amsterdam, The Netherlands
  7. 7 Department of Pediatrics and Neonatology, North West Hospital Group, Alkmaar, The Netherlands
  8. 8 Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands
  9. 9 Department of Pediatrics, OLVG, Amsterdam, The Netherlands
  10. 10 Department of Pediatrics, Flevoziekenhuis, Almere, The Netherlands
  11. 11 Department of Pediatrics, Zaans Medical Center, Zaandam, The Netherlands
  12. 12 Department of Pediatrics, Spaarne Hospital Haarlem, Haarlem, The Netherlands
  13. 13 Department of Pediatrics, Red Cross Hospital, Beverwijk, The Netherlands
  14. 14 Department of Pediatrics, Amstelland Hospital, Amstelveen, The Netherlands
  15. 15 Department of Pediatrics, Bovenij Hospital, Amsterdam, The Netherlands
  16. 16 Psychosocial Department, Emma Children's Hospital UMC, Amsterdam, The Netherlands
  17. 17 Department of Neonatology, Emma Children's Hospital UMC, Amsterdam, The Netherlands
  18. 18 Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
  1. Correspondence to Dr Wes Onland, Amsterdam UMC Locatie AMC, Amsterdam 1105, The Netherlands; w.onland{at}amsterdamumc.nl

Abstract

Objective To compare the association of the severity categories of the 2001-National Institutes of Health (NIH), the 2018-NIH and the 2019-Jensen bronchopulmonary dysplasia (BPD) definitions with neurodevelopmental and respiratory outcomes at 2 and 5 years’ corrected age (CA), and several BPD risk factors.

Design Single-centre historical cohort study with retrospective data collection.

Setting Infants born between 2009 and 2015 at the Amsterdam University Medical Centers, location Amsterdam Medical Center.

Patients Preterm infants born at gestational age (GA) <30 weeks and surviving up to 36 weeks’ postmenstrual age.

Interventions Perinatal characteristics, (social) demographics and comorbidities were collected from the electronic patient records.

Main outcome measures The primary outcomes were neurodevelopmental impairment (NDI) or late death, and respiratory morbidity at 2 and 5 years’ CA. Using logistic regression and Brier scores, we investigated if the ordinal grade severity is associated with incremental increase of adverse long-term outcomes.

Results 584 preterm infants (median GA: 28.1 weeks) were included and classified according to the three BPD definitions. None of the definitions showed a clear ordinal incremental increase of risk for any of the outcomes with increasing severity classification. No significant differences were found between the three BPD definitions (Brier scores 0.169–0.230). Respiratory interventions, but not GA, birth weight or small for GA, showed an ordinal relationship with BPD severity in all three BPD definitions.

Conclusion The severity classification of three BPD definitions showed low accuracy of the probability forecast on NDI or late death and respiratory morbidity at 2 and 5 years’ CA, with no differences between the definitions.

  • Respiratory
  • Follow-Up Studies
  • Intensive Care Units, Neonatal
  • Neonatology

Data availability statement

Data are available upon reasonable request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/archdischild-2024-326931

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request.

    View Full Text

    Supplementary materials

    Footnotes

    • Contributors TAK contributed to the conception and design of the study, acquisition of data, analysis and interpretation of data, and drafting of the manuscript. SB, GJB, AAMWvK, HvL, CAML, MR, IAS, NCR, FV and EvS contributed to the acquisition of data and critical revision of the manuscript. CSHA-M and AGvW-L contributed to the acquisition of data, analysis and interpretation of data and critical revision of the manuscript. WO contributed to the conception and design of the study, acquisition of data, analysis and interpretation of data, and critical revision of the manuscript. WO serves as guaranteer of this paper. All authors approved the final version of the manuscript to be published and agree to be accountable for all aspects of the work.

    • 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.