@article {Avila-Alvarez143, author = {Alejandro Avila-Alvarez and Carlos Zozaya and Sonia P{\'e}rtega-Diaz and Manuel Sanchez-Luna and Martin Iriondo-Sanz and Maria Dolores Elorza and Ferm{\'\i}n Garc{\'\i}a-Mu{\~n}oz Rodrigo}, editor = {, and , and Ginovart, Gemma and Aloy, Josep Figueras and Legorburu, Alberto P{\'e}rez and Olmos, Ramon Aguilera and L{\'o}pez, Eduardo Narbona and Terroba, Sandra and Sanchez-Tamayo, Tom{\'a}s and Fernandez, Dolores Elorza and S{\'a}nchez, Araceli Corredera and Colomer, Bel{\'e}n Fern{\'a}ndez and Fernandez, Ma Angeles Martinez and Ter{\'a}n, De las Cuevas and Altuna, Miguel Cortajarena and D{\'\i}az, Carmen Macias and Jorge, Pedro Fuster and Gracia, Segundo Rite and Faci, Purificaci{\'o}n Ventura and Maci{\'a}n, Isabel Izquierdo and Escobar-Izquierdo, Ana Bel{\'e}n and Pico, Luz Couce and Gutierrez-Gonz{\'a}lez, Elena Pilar and Blanco Bravo, D and Prado, Yolanda Ruiz del and Mart{\'\i}, Lourdes Urqu{\'\i}a and Mozo, Rafael Garcia and Caballero, Pilar Jaraba and Mart{\'\i}nez, Cristina de Frutos and Mart{\'\i}nez-Nadal, S{\'\i}lvia and Iriondo, Martin and Serna, Amaya Rodriguez and Santacruz, Mar{\'\i}a Gonzalez and Moreno-Galdo, Maria Fernanda and Barnusell, Joan Badia and Vicente, Mar Montejo and Alb{\'u}jar, Aintzane Euba; Mar and Perez, Irene Cuadrado and Gutierrez, Andres Martinez and Galiana, Gemma Ginovart and Cuesta, Jes{\'u}s L{\'o}pez and Mu{\~n}oz, Jos{\'e} Santos and Albo, Mar{\'\i}a Su{\'a}rez and Marug{\'a}n-Isabel, V{\'\i}ctor Manuel and Ramos, Mar{\'\i}a Victoria and Modamio, Gerardo Romera and Vizca{\'\i}no, Carolina and Navarro, David Mora and Gordillo, Laura Acosta and Mir, Eduard Soler and Asensio, Mercedes Granero and Capell, Javier Esta{\~n} and Garc{\'\i}a-Cabezas, Miguel Angel and L{\'o}pez G{\'o}mez, D and Fagundo, Alberto Trujillo and Sanz, Israel Anquela and Arenas, Antonio Segado and Pall{\'a}s-Alonso, Carmen Rosa and Romero, Sabina and Armengod, Carmen Gonz{\'a}lez and Lloreda-Garc{\'\i}a, Jose Mar{\'\i}a and Comeche, Laura Domingo and Vilella, Laura Castells and Orayen, Concepci{\'o}n Go{\~n}i and Sebastian, Dolores Muro and Diaz, Mara Fernandez and Victori, Elena Garc{\'\i}a}, title = {Temporal trends in respiratory care and bronchopulmonary dysplasia in very preterm infants over a 10-year period in Spain}, volume = {107}, number = {2}, pages = {143--149}, year = {2022}, doi = {10.1136/archdischild-2021-322402}, publisher = {BMJ Publishing Group}, abstract = {Objective To evaluate trends in respiratory care practices and bronchopulmonary dysplasia (BPD) among very preterm infants born in Spain between 2010 and 2019.Study design This was a retrospective cohort study of data obtained from a national population-based database (SEN1500 network). Changes in respiratory care and BPD-free survival of infants with gestational age (GA) of 230{\textendash}316 weeks and \<1500 g were assessed over two 5-year periods. Temporal trends were examined by joinpoint and Poisson regression models and expressed as the annual per cent change and adjusted relative risk (RR) for the change per year.Results A total of 17 952 infants were included. In the second period, infants were less frequently intubated in the delivery room and during neonatal intensive care unit stay. This corresponded with an increase in use of non-invasive ventilation techniques. There were no significant differences between the periods in BPD-free survival or survival without moderate-to-severe BPD. After adjusting for covariates, the RR for the change per year was significant for the following variables: never intubated (RR 1.03, 95\% CI 1.02 to 1.04); intubation in the delivery room (RR 0.98, 95\% CI 0.97 to 0.99); use of nasal intermittent positive pressure ventilation (RR 1.08, 95\% CI 1.05 to 1.11); and BPD-free survival (only in the group with the lowest GA; RR 0.98, 95\% CI 0.97 to 0.99).Conclusion Our findings reveal significant changes in respiratory care practices between 2009 and 2019. Despite an increase in use of non-invasive respiratory strategies, BPD-free survival did not improve and even worsened in the group with the lowest GA (230{\textendash}256).Data supporting the findings of this study (deidentified participant data) are available upon request to the corresponding author.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/107/2/143}, eprint = {https://fn.bmj.com/content/107/2/143.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }