Brener Dik Pablo H, Niño Gualdron Yeimy M, Galletti María F, Cribioli Carolina M, Mariani Gonzalo L
Departamento de Pediatría, Servicio de Neonatologia, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires.
Arch Argent Pediatr. 2017 Oct 1;115(5):476-482. doi: 10.5546/aap.2017.eng.476.
Bronchopulmonary dysplasia is the most common chronic pulmonary sequela among very low birth weight infants. The objective of this study was to estimate its incidence in our Neonatal Unit over the past 5 years and analyze associated risk factors.
An observational and analytical study was conducted in a retrospective cohort, using data obtained from a prospective database of infants born at Hospital Italiano de Buenos Aires with a birth weight of less than 1500 grams between January 2010 and December 2014. The incidence of bronchopulmonary dysplasia and its association with several secondary outcome measures were studied.
Two hundred and forty-five patients were included. The incidence of moderate/severe bronchopulmonary dysplasia was 22%, and it was associated with a younger gestational age and lower birth weight. A significant association was observed with surfactant use, mechanical ventilation requirement, and length of mechanical ventilation. Patients with moderate/severe bronchopulmonary dysplasia had a higher incidence of patent ductus arteriosus and late-onset sepsis. A lower birth weight (adjusted odds ratio |-#91;aOR|-#93;: 0.99, 95% confidence interval |-#91;CI|-#93;: 0.991-0.997, p< 0.001) and the length of mechanical ventilation (aOR: 1.08, 95% CI: 1.01-1.15, p < 0.01) remained associated following adjustment for other outcome measures. In addition, an association was observed among patients with intrauterine growth restriction born at less than 32 weeks of gestational age (OR: 4.71, 95% CI: 1.68-13.2).
The incidence ofbronchopulmonary dysplasia in our unit was associated with a lower birth weight and the length of mechanical ventilation. Among infants born at less than 32 weeks of gestation, intrauterine growth restriction accounted for an additional risk.
支气管肺发育不良是极低出生体重儿中最常见的慢性肺部后遗症。本研究的目的是评估过去5年我院新生儿科中其发病率，并分析相关危险因素。
采用回顾性队列研究进行观察性和分析性研究，使用从意大利布宜诺斯艾利斯医院前瞻性数据库中获取的数据，该数据库记录了2010年1月至2014年12月期间出生体重小于1500克的婴儿。研究了支气管肺发育不良的发病率及其与几种次要结局指标的关联。
纳入245例患者。中重度支气管肺发育不良的发病率为22%，且与孕周较小和出生体重较低有关。观察到与使用表面活性剂、需要机械通气以及机械通气时间存在显著关联。中重度支气管肺发育不良患者动脉导管未闭和晚发性败血症的发病率较高。在对其他结局指标进行调整后，较低的出生体重（调整优势比[aOR]：0.99，95%置信区间[CI]：0.991 - 0.997，p < 0.001）和机械通气时间（aOR：1.08，95% CI：1.01 - 1.15，p < 0.01）仍然具有相关性。此外，在孕周小于32周出生的宫内生长受限患者中观察到一种关联（优势比[OR]：4.71，95% CI：1.68 - 13.2）。
我院支气管肺发育不良的发病率与较低的出生体重和机械通气时间有关。在孕周小于32周出生的婴儿中，宫内生长受限是另一个额外的风险因素。
