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支气管肺发育不良定义的比较:一项队列研究

Comparison of Definitions for Bronchopulmonary Dysplasia: A Cohort Study.

作者信息

Okulu Emel, Kraja Elvis, Kostekci Yasemin Ezgi, Aloyeva Rana, Erdeve Omer, Atasay Begum, Arsan Saadet

机构信息

Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey.

Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey.

出版信息

Z Geburtshilfe Neonatol. 2023 Feb;227(1):58-63. doi: 10.1055/a-1915-5682. Epub 2022 Sep 7.

Abstract

We aimed to compare the definitions of National Institute of Child Health and Human Development (NICHD) for bronchopulmonary dysplasia (BPD) for determining the incidences, and predicting late death and respiratory outcome. This retrospective cohort study included infants born at<32 weeks' gestation who survived up to 36 weeks' postmenstrual age (PMA). Infants were classified as having BPD or no BPD per thedefinitions of NICHD 2001 and 2018. The incidences of BPD were 49 and 32% according to the 2001 and 2018 NICHD definitions. Gestational age, birth weight and intubation after birth were associated with BPD by both definitions. The NICHD 2018 definition displayed similar sensitivity (100%) and negative predictive value (100%), and higher specificity (70 vs. 52%) for predicting death after 36 weeks' PMA; a higher specificity (72 vs. 53%), comparable negative predictive value (77 vs.76%), but lower sensitivity for predicting adverse respiratory outcome within 12 months corrected age compared with the NICHD 2001 definition. The NICHD 2018 definition is as powerful as the 2001 definition for predicting late death and seems to be a better indicator for long-term respiratory outcome. The use of supplemental oxygen or oxygen plus respiratory support should be considered while predicting both late death and long-term respiratory outcome.

摘要

我们旨在比较美国国立儿童健康与人类发展研究所(NICHD)对支气管肺发育不良(BPD)的定义,以确定其发病率,并预测晚期死亡和呼吸结局。这项回顾性队列研究纳入了妊娠<32周出生且存活至孕龄36周(PMA)的婴儿。根据NICHD 2001年和2018年的定义,将婴儿分为患有BPD或未患有BPD。根据2001年和2018年NICHD的定义,BPD的发病率分别为49%和32%。两种定义下,胎龄、出生体重和出生后插管均与BPD相关。NICHD 2018年的定义在预测孕龄36周后的死亡方面显示出相似的敏感性(100%)和阴性预测值(100%),以及更高的特异性(分别为70%和52%);与NICHD 2001年的定义相比,在预测矫正年龄12个月内不良呼吸结局方面,特异性更高(分别为72%和53%),阴性预测值相当(分别为77%和76%),但敏感性较低。NICHD 2018年的定义在预测晚期死亡方面与2001年的定义同样有效,并且似乎是长期呼吸结局的更好指标。在预测晚期死亡和长期呼吸结局时,应考虑使用补充氧气或氧气加呼吸支持。

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