Influencing factors for bronchopulmonary dysplasia in VLBWI and ELBWI / 国际儿科学杂志

ABSTRACT

Objective To explore causes and clinical factors associated with bronchopulmonary dyspla-sia( BPD) in very low birth weight infant ( VLBWI) and extremely low birth weight infant( ELBWI) . Methods A retrospective analysis was performed on the clinical data of VLBWI and ELBWI,whose birth weight less than1200g and diagnosed BPD in NICU of Shengjing Hospital between Jan. 1st 2010 and Dec. 31st 2014. No-BPD infants with the same birth weight and during the same period were selected as the control group. Results One handred and twenty-eight cases met the criteria of BPD,whose mean gestational age(GA) was (28. 6 ± 1. 8)weeks. Other 121cases were no-BPD,and mean GA was (30. 8 ± 1. 8)weeks. Maternal hypertension during pregnancy,gestational age,birth weight,small for age infant were lower in BPD group than those in no-BPD group. Prenatal infection,premature rupture of membrances≥18h,cesarean delivery,male,Apgar 1min≤3,intra-partum recovery,alveolar surface active substances,mechanical ventilation and the time,oxygen time were higher in BPD group than those in no-BPD group. Logistic regression analysis indicated that low gestational age( OR=1. 014,P<0. 05),male(OR=2. 771,P<0. 05),duration of invasive mechanical ventilation(OR=1. 014,P<0. 05),duration of CPAP(OR=1. 008,P<0. 05)lead to BPD. Multiple logistic regression model showed that Apgar 1min≤3(95％CI1. 274～14. 017,χ2 = 5. 550,P=0. 018,OR=4. 226),duration of invasive mechanical ventilation(95％CI1. 001 ～1. 004,χ2 =10. 410,P =0. 001,OR =1. 003),PDA surgery(95％CI1. 345 ～129. 693,χ2 =4. 904,P=0. 027,OR=13. 210) were the independent risk factors for the moderate-severe BPD. Conclusion Our study showed that low GA,male,long duration of mechanical ventilation were risk factors of the development of BPD. Apgar 1min≤3,duration of mechanical ventilation,PDA surgery were related with moderate-severe BPD.