Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Family Medicine & Public Health, Sultan Qaboos University, Muscat, Oman.
Sultan Qaboos Univ Med J. 2024 May;24(2):259-267. doi: 10.18295/squmj.3.2024.017. Epub 2024 May 27.
This study aimed to determine the rate and severity patterns of bronchopulmonary dysplasia (BPD) and identify antenatal and postnatal factors associated with BPD in preterm infants <32 weeks of gestational age (GA).
This retrospective observational study included preterm neonates <32 weeks of gestation admitted into the neonatal intensive care unit between January 2010 and December 2017 at Sultan Qaboos University Hospital, Muscat, Oman. A data set of antenatal and perinatal factors were collected. BPD was defined as the need for oxygen and/or respiratory support at 36 weeks post-menstrual age (PMA). Infants with and without BPD were compared in their antenatal and perinatal factors.
A total of 589 preterm infants <32 weeks were admitted. Among them, 505 (85.7%) survived to 36 weeks' PMA and 90 (17.8%) had BPD. The combined BPD and mortality rate was 28.4%. Grades 1, 2 and 3 BPD constituted 77.8%, 7.8% and 14.4%, respectively. BPD was associated with lower GA, lower birth weight, need for intubation at resuscitation, lower Apgar scores, longer duration of ventilation, surfactant therapy and higher rates of neonatal morbidities. On binary logistic regression analysis, predictors of BPD were longer duration of ventilation, intraventricular haemorrhage (IVH) and necrotising enterocolitis (NEC).
In an Omani centre, 17.8% of preterm infants (<32 weeks GA) developed BPD. Various perinatal and neonatal factors were associated with BPD. However, longer duration of ventilation, IVH grades 1 and 2 and NEC stages II and III were significant predictors. Future multicentre research is necessary to provide the overall prevalence of BPD in Oman to help optimise the resources for BPD prevention and management in preterm infants.
本研究旨在确定支气管肺发育不良（BPD）的发生率和严重程度模式，并确定胎龄<32 周的早产儿发生 BPD 的产前和产后因素。
本回顾性观察性研究纳入了 2010 年 1 月至 2017 年 12 月在阿曼马斯喀特苏丹卡布斯大学医院新生儿重症监护病房住院的胎龄<32 周的早产儿。收集了产前和围产期因素的数据。BPD 定义为在胎龄 36 周时需要氧气和/或呼吸支持。比较了有和没有 BPD 的婴儿的产前和围产期因素。
共纳入 589 名胎龄<32 周的早产儿。其中，505 名（85.7%）存活至胎龄 36 周，90 名（17.8%）患有 BPD。BPD 和死亡率的总和为 28.4%。1 级、2 级和 3 级 BPD 分别占 77.8%、7.8%和 14.4%。BPD 与胎龄较低、出生体重较低、复苏时需要插管、较低的 Apgar 评分、更长的通气时间、表面活性剂治疗和更高的新生儿发病率有关。在二元逻辑回归分析中，BPD 的预测因素是通气时间延长、室管膜下出血（IVH）和坏死性小肠结肠炎（NEC）。
在阿曼的一个中心，17.8%的胎龄<32 周的早产儿（GA）发生了 BPD。各种围产期和新生儿因素与 BPD 有关。然而，通气时间延长、IVH 1 级和 2 级以及 NEC 2 期和 3 期是显著的预测因素。未来的多中心研究有必要提供阿曼 BPD 的总体患病率，以帮助优化早产儿 BPD 预防和管理的资源。
