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中国支气管肺发育不良早产儿的时点患病率、特征和治疗差异:一项“快照”研究。

Point prevalence, characteristics and treatment variations for preterm infants with bronchopulmonary dysplasia in China: a 'snapshot' study.

机构信息

Division of Neonatology and Center for Newborn Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, People's Republic of China.

Division of Neonatology and Center for Newborn Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, People's Republic of China

出版信息

BMJ Paediatr Open. 2024 Oct 4;8(1):e002878. doi: 10.1136/bmjpo-2024-002878.

Abstract

OBJECTIVE

The incidence of bronchopulmonary dysplasia (BPD) is increasing, but data on its prevalence and management variations remain insufficient in China. The study aims to investigate its point prevalence and variations in BPD care.

SETTING, PATIENTS AND INTERVENTIONS: A multicentre cross-sectional study was conducted in 37 NICUs. 'Snapshot' clinical data on 18 June 2021 for individual patients born at <32 weeks gestation age (GA) were collected. BPD was defined based on the National Institute of Child Health and Human Development (NICHD) 2001 criteria and two newer criteria (NICHD 2018 and Jensen 2019).

RESULTS

A total of 1044 infants born at <32 weeks GA were included, of which 72% were born at ≥28 weeks GA and 95.8% were born at ≥750 g. At the time of 'snapshot', 563 were ≥28 days old and 281 were ≥36 weeks postmenstrual age (PMA). The prevalence of BPD was 78.2% per NICHD 2001 definition. Infants with BPD were more likely to be born earlier with a lower birth weight and to have complications. Among infants who reached 36 weeks PMA, the point prevalence and severity of BPD differed across BPD definitions. Respiratory support and treatments for BPD also significantly varied.

CONCLUSION

Point prevalence of BPD is remarkably high in China. The prevalence of BPD was lowest according to the NICHD 2018 definition, whereas the NICHD 2001 definition classified most patients with severe BPD. We found infants with BPD have more complications and significant differences in BPD treatments between centres. Efforts to prevent BPD and standardise care are warranted in China.

摘要

目的

支气管肺发育不良(BPD)的发病率正在上升,但中国关于其患病率和管理差异的数据仍然不足。本研究旨在调查其现患率和 BPD 护理差异。

设置、患者和干预措施:一项多中心横断面研究在 37 家 NICU 进行。于 2021 年 6 月 18 日收集了胎龄(GA)<32 周的每位患者的“快照”临床数据。BPD 根据美国国立儿童健康与人类发育研究所(NICHD)2001 标准和两种新标准(NICHD 2018 年和 Jensen 2019 年)进行定义。

结果

共纳入 1044 名胎龄<32 周的婴儿,其中 72%出生于≥28 周 GA,95.8%出生于≥750g。在“快照”时,563 名婴儿≥28 天,281 名婴儿≥36 周校正胎龄(PMA)。根据 NICHD 2001 定义,BPD 的现患率为 78.2%。患有 BPD 的婴儿更有可能早产,出生体重更低,并伴有并发症。在达到 36 周 PMA 的婴儿中,不同 BPD 定义的 BPD 现患率和严重程度不同。用于治疗 BPD 的呼吸支持和治疗方法也存在显著差异。

结论

中国 BPD 的现患率非常高。根据 NICHD 2018 定义,BPD 的现患率最低,而 NICHD 2001 定义将大多数患有严重 BPD 的患者进行了分类。我们发现患有 BPD 的婴儿并发症更多,且各中心之间的 BPD 治疗存在显著差异。中国有必要预防 BPD 和标准化护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24d9/11481134/72127594d483/bmjpo-8-1-g001.jpg

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