Pediatric University Hospital, University of Saarland, Homburg, Germany.
Neonatology. 2011;99(2):112-7. doi: 10.1159/000313024. Epub 2010 Aug 23.
A considerable local variability in the rate of bronchopulmonary dysplasia (BPD) has been recorded previously.
The objectives of the present study were to describe regional differences in the rate of BPD in very preterm neonates from a European population-based cohort and to further delineate risk factors.
4,185 survivors to 36 weeks' postmenstrual age of 4,984 live-born infants born at 24+0-31+6 weeks' gestation in 2003 (the MOSAIC cohort) in 10 European regions were enrolled using predefined structured questionnaires.
Overall median gestational age of preterms without BPD was 30 weeks (range 23-31), median birth weight 1,320 g (range 490-3,150) compared with 27 weeks (23-31) and 900 g (370-2,460) in those with BPD. The region-specific crude rate of BPD ranged from 10.2% (Italian region) to 24.8% (UK Northern region). Maternal hypertension, immaturity, male gender, small for gestational age, Apgar <7 and region of care were associated with an increased incidence of BPD on multivariate analysis.
A wide variability of BPD between European regions may be explained by different local practices; the strongest association however was with degree of immaturity.
此前已有研究记录到支气管肺发育不良（BPD）的发生率存在显著的地区差异。
本研究旨在描述来自欧洲基于人群队列的极早产儿中 BPD 发生率的地区差异，并进一步阐明其危险因素。
2003 年，在欧洲的 10 个地区，采用预定的结构化问卷，对胎龄为 24+0-31+6 周、出生时存活的 4984 例活产儿中 4185 例（MOSAIC 队列）在 36 周龄前存活的患儿进行了研究。
无 BPD 的早产儿的总体中位胎龄为 30 周（范围为 23-31），中位出生体重为 1320g（范围为 490-3150），而有 BPD 的早产儿则分别为 27 周（23-31）和 900g（370-2460）。BPD 的地区特异性粗发生率范围为 10.2%（意大利地区）至 24.8%（英国北部地区）。多变量分析显示，母亲高血压、不成熟、男性、小于胎龄儿、Apgar<7 分和照护地区与 BPD 发生率增加相关。
欧洲地区之间 BPD 的差异很大，可能是由于不同的当地实践所致；但与不成熟程度的关联最强。
