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支气管肺发育不良:高原地区早产儿的发病率和严重程度。

Bronchopulmonary dysplasia: Incidence and severity in premature infants born at high altitude.

机构信息

Departamento de farmacología y Toxicologia, Grupo de Investigación en Farmacología y Toxicología, Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia.

Corporación Universitaria Remington, Medellin, Colombia.

出版信息

Pediatr Pulmonol. 2022 Feb;57(2):470-475. doi: 10.1002/ppul.25763. Epub 2021 Nov 30.

DOI:10.1002/ppul.25763
PMID:34796697
Abstract

BACKGROUND

Bronchopulmonary dysplasia (BPD) is the most common cause of chronic lung disease in children born prematurely. There is little information about the epidemiology and severity of BPD places with high altitude. This study aimed to evaluate the frequency of BPD severity levels and the associated risk factors with severity in a cohort of preterm newborns ≤36weeks of gestational age born in Rionegro, Colombia MATERIALS AND METHODS: We carried out a retrospective analytical cohort of preterm newborns without major malformations from Rionegro, Colombia between 2011 and 2018 admitted to neonatal intensive unit at high altitude (2200 m above sea level). The main outcomes were the incidence and severity of BPD.

RESULTS

The BPD incidence was 23.5% 95% (confidence interval [CI], 19.6-27.7). BPD was grade 1 in 69.9%, grade 2 in 15.5% and grade 3 in 14.5% of patients. After modeling regression analysis, the final variables associated with BPD severity levels were: sepsis (odds ratio [OR], 4.15; 95% CI, 1.33-12.96) and pulmonary hypertension (OR: 3.86; 95% CI, 1.30-11.4).

CONCLUSION

The incidence of BPD was higher and similar to cities with higher altitudes. In our population, the variables associated with BPD severity levels were: sepsis and pulmonary hypertension. It is necessary to increase the awareness of risk factors, the effect of clinical practices, and early recognition of BPD to reduce morbidity in patients with this pathology.

摘要

背景

支气管肺发育不良(BPD)是早产儿中最常见的慢性肺部疾病。关于高海拔地区 BPD 的流行病学和严重程度的信息很少。本研究旨在评估在哥伦比亚里奥内格罗(Rionegro)出生的≤36 周龄早产儿队列中 BPD 严重程度水平的频率及其与严重程度相关的危险因素。

材料和方法

我们进行了一项回顾性分析性队列研究,纳入了 2011 年至 2018 年期间在哥伦比亚里奥内格罗(Rionegro)出生的无重大畸形的早产儿,这些早产儿被收入高海拔(海拔 2200 米以上)新生儿重症监护病房。主要结局为 BPD 的发生率和严重程度。

结果

BPD 的发生率为 23.5%(95%置信区间[CI],19.6-27.7)。BPD 分级 1 占 69.9%,2 级占 15.5%,3 级占 14.5%。在回归分析模型后,与 BPD 严重程度相关的最终变量为:败血症(比值比[OR],4.15;95%CI,1.33-12.96)和肺动脉高压(OR:3.86;95%CI,1.30-11.4)。

结论

BPD 的发生率较高,与海拔较高的城市相似。在我们的人群中,与 BPD 严重程度相关的变量为:败血症和肺动脉高压。需要提高对危险因素、临床实践效果以及 BPD 早期识别的认识,以降低患有这种疾病的患者的发病率。

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