Uberos Jose, Ruiz-López Aida, Fernández-Romero Carlos, Fernández-Marin Elizabeth, Cubero-Millan Isabel, Contreras-Chova Francisco, Campos-Martínez Ana
School of Medicine, University of Granada, Granada, Spain.
Neonatal Intensive Care Unit, San Cecilio Clinical Hospital, Granada, Spain.
J Paediatr Child Health. 2025 Feb;61(2):209-215. doi: 10.1111/jpc.16731. Epub 2024 Dec 9.
To determine the predictive value of the definition of bronchopulmonary dysplasia (BPD) on spirometric parameters of very low birthweight (VLBW) children of school age between 1 January 2008 and 31 December 2016.
In this longitudinal retrospective observational study, we analyse a cohort of children admitted to a neonatal intensive care unit between 1 January 2008 and 31 December 2016. All newborns weighing <1500 g and born before 32 weeks of gestational age were included in the study (VLBW newborns). The existence of BPD was established retrospectively according to the definitions proposed by the National Institutes of Health (NIH) in 2001 and the National Institute of Child Health and Human Development (NICHD) in 2018. Lung function of the school-age cohort was evaluated prospectively as FEV1, FVC, FEF and FEV1/FVC by spirometry. The predictive analysis was performed by multivariate linear regression.
Of the 145 children included in the study cohort, 60 were diagnosed with BPD according to the NIH definition and 36 according to that of the NICHD. Lung function was reduced by about 20% in patients with BPD, irrespective of the definition applied. However, the predictive regression model only produced a statistically significant fit with the spirometric variables when the NIH definition was adopted.
Our findings highlight the value of continuing to consider oxygen requirements at 28 days of chronological age in the definition of BPD, in order to obtain higher quality predictions of lung function parameters assessed later, during school age.
确定2008年1月1日至2016年12月31日期间学龄期极低出生体重（VLBW）儿童支气管肺发育不良（BPD）的定义对肺功能参数的预测价值。
在这项纵向回顾性观察研究中，我们分析了2008年1月1日至2016年12月31日期间入住新生儿重症监护病房的一组儿童。所有出生体重<1500g且胎龄<32周的新生儿均纳入研究（VLBW新生儿）。根据美国国立卫生研究院（NIH）2001年和美国国立儿童健康与人类发展研究所（NICHD）2018年提出的定义，回顾性确定BPD的存在情况。通过肺功能仪对学龄期队列的肺功能进行前瞻性评估，测定第一秒用力呼气容积（FEV1）、用力肺活量（FVC）、用力呼气流量（FEF）和FEV1/FVC。采用多元线性回归进行预测分析。
在纳入研究队列的145名儿童中，根据NIH定义，60名被诊断为BPD，根据NICHD定义，36名被诊断为BPD。无论采用哪种定义，BPD患者的肺功能均下降约20%。然而，只有采用NIH定义时，预测回归模型才与肺功能仪变量产生具有统计学意义的拟合。
我们的研究结果强调了在BPD定义中继续考虑出生后28天氧需求的价值，以便对学龄期后期评估的肺功能参数获得更高质量的预测。
