Kwinta Przemko, Grudzień Andrzej, Pawlik Dorota, Olechowski Wiesław, Lauterbach Ryszard, Pietrzyk Jacek J
Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medium w Krakowie.
Przegl Lek. 2009;66(1-2):14-20.
Advances in intensive health care within the last 30 years have resulted in increased survival of most immature neonates. The results of epidemiological studies indicate, however, that late complications of prematurity, including bronchopulmonary dysplasia (BPD), have become more frequent since the late 1990s. The identification of risk factors predisposing to severe BPD might help in developing treatment methods directed at the group of children with high risk of developing the disease.
Analysis of prevalence and risk factors of bronchopulmonary dysplasia among extremely low birth weight newborns of regional birth cohort of south-east Poland.
The study included newborns of birth weight < or = 1000g born in south-east district of Poland within one calendar year. The data assessed were: the need of oxygen therapy of at least 28 days' duration and the need of oxygen therapy at 36 weeks of postmenstrual age (PMA).
During the study period 109 newborns with birth weight < or = 1000g) were hospitalized in three third-level departments of neonatology in south-east Poland. The final assessment for BPD included 56 children (51%), whose mean birth weight was 839g (SD: 128) and mean gestational age was 27.3 weeks (SD: 2.2). Thirty-nine children (70%) required oxygen therapy for at least 28 days, and 27 children (48%) required oxygen therapy at 36 weeks of PMA. Gestational age of the newborn, the need of respiratory support at birth, and the need of surgical treatment of PDA were found to be independent risk factors of oxygen therapy lasting for at least 28 days. Only the need of respiratory support at 7 days of life and the need for surgical treatment of PDA were found to be independent risk factors of oxygen therapy at the 36 weeks of PMA.
The analysis of several risk factors of BPD in children with birth weight < or =1000g revealed that the need for respiratory support at seven days of life is a major risk factor of developing chronic respiratory disease. The risk of BPD may be significantly reduced by adequate care aimed at shortening the time of conventional respiratory support and at limiting the persistence of ductus arteriosus.
过去30年中重症医疗护理的进步使大多数未成熟新生儿的存活率有所提高。然而，流行病学研究结果表明，自20世纪90年代末以来，早产的晚期并发症，包括支气管肺发育不良（BPD），变得更加常见。识别导致严重BPD的危险因素可能有助于开发针对有该疾病高风险儿童群体的治疗方法。
分析波兰东南部地区出生队列中极低出生体重新生儿支气管肺发育不良的患病率及危险因素。
该研究纳入了在波兰东南部地区一个日历年内出生体重≤1000g的新生儿。评估的数据包括：至少持续28天的氧疗需求以及孕龄36周时的氧疗需求。
在研究期间，109例出生体重≤1000g的新生儿在波兰东南部的三个三级新生儿科住院。最终诊断为BPD的有56例儿童（51%），其平均出生体重为839g（标准差：128），平均孕龄为27.3周（标准差：2.2）。39例儿童（70%）需要至少28天的氧疗，27例儿童（48%）在孕龄36周时需要氧疗。新生儿的孕龄、出生时对呼吸支持的需求以及动脉导管未闭的手术治疗需求被发现是至少持续28天氧疗的独立危险因素。仅出生7天时对呼吸支持的需求以及动脉导管未闭的手术治疗需求被发现是孕龄36周时氧疗的独立危险因素。
对出生体重≤1000g儿童BPD的多个危险因素分析表明，出生7天时对呼吸支持的需求是发生慢性呼吸道疾病的主要危险因素。通过旨在缩短传统呼吸支持时间和限制动脉导管未闭持续存在的适当护理，可显著降低BPD的风险。
