Department of Pediatrics, Division of Neonatology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA.
University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA.
Respir Res. 2024 May 24;25(1):219. doi: 10.1186/s12931-024-02850-x.
Large-scale estimates of bronchopulmonary dysplasia (BPD) are warranted for adequate prevention and treatment. However, systematic approaches to ascertain rates of BPD are lacking.
To conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤ 1,500 g) or very low gestational age (< 32 weeks) neonates.
A search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed.
Randomized controlled trials and observational studies evaluating rates of BPD in very low birth weight or very low gestational age infants were eligible. Included studies defined BPD as positive pressure ventilation or oxygen requirement at 28 days (BPD28) or at 36 weeks postmenstrual age (BPD36).
Two reviewers independently conducted all stages of the review. Random-effects meta-analysis was used to calculate the pooled prevalence. Subgroup analyses included gestational age group, birth weight group, setting, study period, continent, and gross domestic product. Sensitivity analyses were performed to reduce study heterogeneity.
Prevalence of BPD defined as BPD28, BPD36, and by subgroups.
A total of 105 articles or databases and 780,936 patients were included in this review. The pooled prevalence was 35% (95% CI, 28-42%) for BPD28 (n = 26 datasets, 132,247 neonates), and 21% (95% CI, 19-24%) for BPD36 (n = 70 studies, 672,769 neonates). In subgroup meta-analyses, birth weight category, gestational age category, and continent were strong drivers of the pooled prevalence of BPD.
This study provides a global estimation of BPD prevalence in very low birth weight/low gestation neonates.
为了进行充分的预防和治疗，需要对支气管肺发育不良（BPD）进行大规模的评估。然而，目前缺乏确定 BPD 发病率的系统方法。
进行系统评价和荟萃分析，以评估极低出生体重（≤1500 克）或极早早产儿（<32 周）的 BPD 患病率。
使用与 BPD 和患病率相关的搜索词，对 1990 年 1 月至 2019 年 9 月期间的 MEDLINE 进行了检索。
符合条件的研究为评估极低出生体重或极早早产儿中 BPD 发生率的随机对照试验和观察性研究。纳入的研究将 BPD 定义为正压通气或 28 天（BPD28）或出生后 36 周（BPD36）时需要吸氧。
两位审查员独立进行了审查的所有阶段。使用随机效应荟萃分析计算了汇总患病率。亚组分析包括胎龄组、出生体重组、研究场所、研究时期、大陆和国内生产总值。进行了敏感性分析以减少研究异质性。
BPD28、BPD36 和亚组定义的 BPD 患病率。
本综述共纳入 105 篇文章或数据库和 780936 例患者。BPD28（n=26 项研究，132247 例新生儿）的汇总患病率为 35%（95%CI，28%-42%），BPD36（n=70 项研究，672769 例新生儿）的汇总患病率为 21%（95%CI，19%-24%）。在亚组荟萃分析中，出生体重类别、胎龄类别和大陆是影响 BPD 汇总患病率的主要因素。
本研究提供了极低出生体重/低胎龄新生儿中 BPD 患病率的全球估计值。
