Landry Jennifer S, Menzies Dick
Respiratory Epidemiology & Clinical Research Unit, McGill University, Montreal, Quebec.
Paediatr Child Health. 2011 Aug;16(7):399-403. doi: 10.1093/pch/16.7.399.
Despite notable advances in neonatal care, bronchopulmonary dysplasia (BPD) remains an important complication of preterm birth, frequently resulting in prolonged hospital stay and long-term morbidity.
A historical cohort study of all preterm infants (gestational age younger than 37 weeks) admitted to the Montreal Children's Hospital (Montreal, Quebec) between January 1, 1980, and December 31, 1992, was conducted. Information collected included demographic data, maternal and perinatal history, and main neonatal outcomes. Independent risk factors associated with BPD were identified by univariate analysis using one-way ANOVA, t tests or Mantel-Haenszel χ(2) testing. Severity of disease was studied using an ordinal multinomial logistic regression model.
In total, 1192 preterm infants were admitted, of whom 551 developed respiratory distress syndrome and 322 developed BPD. For each additional week of prematurity, the risk of developing BPD increased by 54% (adjusted OR 1.54/week [95% CI 1.45 to 1.64]). For each point subtracted on the 1 min Apgar score, the risk of developing BPD was increased by 16% (OR 1.16 [95% CI 1.1 to 1.3]). BPD was also associated with the presence of patent ductus arteriosus (OR 3.5 [95% CI 2.1 to 6.0]), pneumothorax in the first 48 h (OR 9.4 [95% CI 3.6 to 24.8]) or neonatal pneumonia/sepsis in the neonatal period (OR 1.9 [95% CI 1.1 to 3.2]). Severity of BPD was associated with gestational age, 1 min Apgar score, very low birth weight and the presence of neonatal pneumonia/sepsis.
Factors associated with BPD following a preterm birth were the degree of prematurity, birth weight, Apgar score at 1 min, and the presence of patent ductus arteriosus, pneumothorax or neonatal pneumonia/sepsis.
尽管新生儿护理取得了显著进展，但支气管肺发育不良（BPD）仍然是早产的一项重要并发症，常常导致住院时间延长和长期发病。
对1980年1月1日至1992年12月31日期间入住蒙特利尔儿童医院（魁北克省蒙特利尔）的所有早产儿（胎龄小于37周）进行了一项历史性队列研究。收集的信息包括人口统计学数据、母亲和围产期病史以及主要的新生儿结局。使用单向方差分析、t检验或曼特尔 - 亨泽尔χ²检验通过单变量分析确定与BPD相关的独立危险因素。使用有序多项逻辑回归模型研究疾病的严重程度。
总共1192名早产儿入院，其中551名发生呼吸窘迫综合征，322名发生BPD。每早产一周，发生BPD的风险增加54%（校正比值比为1.54/周[95%置信区间为1.45至1.64]）。1分钟阿氏评分每降低1分，发生BPD的风险增加16%（比值比为1.16[95%置信区间为1.1至1.3]）。BPD还与动脉导管未闭有关（比值比为3.5[95%置信区间为2.1至6.0]）、出生后48小时内发生气胸（比值比为9.4[95%置信区间为3.6至24.8]）或新生儿期发生新生儿肺炎/败血症（比值比为1.9[95%置信区间为1.1至3.2]）。BPD的严重程度与胎龄、1分钟阿氏评分、极低出生体重以及新生儿肺炎/败血症的存在有关。
早产之后与BPD相关的因素包括早产程度、出生体重、1分钟阿氏评分以及动脉导管未闭、气胸或新生儿肺炎/败血症的存在。
