Abbas Kirellos Said, Al-Matary Abdulrahman, Elabd Rawan, Fouad Michele, Badreldin Nouran, Sharara Muhannad, Elsebey Moustafa, Dobs Monica, Qureshi Adnan I, Adi Abdul Rahman, Ghawi Afrah, Alahmadi Ghadeer Ghazi, Alyahyawi Huda Yahya, Mazi Ahlam, Alyoubi Reem Abdullah
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Neonatology, King Fahad Medical City, Riyadh, Saudi Arabia.
Ann Pediatr Cardiol. 2024 Jul-Aug;17(4):250-256. doi: 10.4103/apc.apc_118_24. Epub 2024 Nov 15.
Bronchopulmonary dysplasia (BPD) poses a challenge in neonatal care. Previous literature recommended a hypothetical role for patent ductus arteriosus (PDA) in the development of BPD. This study explores the possible link between PDA and BPD, aiming to illuminate demographic and clinical factors influencing BPD development within the context of PDA.
This retrospective cohort analysis employed data from the National Inpatient Sample (NIS) spanning from 2016 to 2020. The study focused on patients diagnosed with PDA and BPD, identified through International Classification of Diseases 10 Revision codes Q250 and P271, respectively. Utilizing STATA ×15, descriptive and inferential statistics, encompassing univariate and multivariate regression analyses, were conducted to examine the association between PDA and BPD.
A total of 9737 patients were included: 5133 without PDA and 4604 with PDA. The mortality rate was significantly higher among patients with PDA (3.80%) compared to those without PDA (2.53%) ( < 0.0001). Univariate and multivariate regression analyses identified a significant association between PDA and BPD, with odds ratios of 14.62 and 2.43, respectively (both < 0.0001). BPD patients with PDA also exhibited a significantly higher prevalence of extremely preterm birth (76.24% vs. 58.31%, < 0.0001) and extremely low birth weight (65.57% vs. 42.70%, < 0.0001) compared to BPD patients without PDA. In addition, significant associations were observed between BPD and factors such as preterm birth category, neonatal sepsis, race, hospital status, and region (all < 0.0001).
This research confirms the connection between PDA and BPD, stressing the importance of continued investigation and prospective studies. The findings highlight the need to consider several factors in understanding the etiology of the disease, which could lead to more targeted interventions and improved patient care.
支气管肺发育不良（BPD）给新生儿护理带来了挑战。以往文献提出动脉导管未闭（PDA）在BPD发生过程中可能发挥的作用。本研究探讨PDA与BPD之间的可能联系，旨在阐明在PDA背景下影响BPD发生的人口统计学和临床因素。
本回顾性队列分析采用了2016年至2020年国家住院患者样本（NIS）的数据。该研究聚焦于分别通过国际疾病分类第10版编码Q250和P271确诊为PDA和BPD的患者。利用STATA×15进行描述性和推断性统计，包括单变量和多变量回归分析，以检验PDA与BPD之间的关联。
共纳入9737例患者：5133例无PDA，4604例有PDA。有PDA的患者死亡率（3.80%）显著高于无PDA的患者（2.53%）（<0.0001）。单变量和多变量回归分析确定PDA与BPD之间存在显著关联，比值比分别为14.62和2.43（均<0.0001）。与无PDA的BPD患者相比，有PDA的BPD患者极早产（76.24%对58.31%，<0.0001）和极低出生体重（65.57%对42.70%，<0.0001）的患病率也显著更高。此外，还观察到BPD与早产类型、新生儿败血症、种族、医院状况和地区等因素之间存在显著关联（均<0.0001）。
本研究证实了PDA与BPD之间的联系，强调了持续调查和前瞻性研究的重要性。研究结果突出了在理解该疾病病因时考虑多种因素的必要性，这可能会带来更有针对性的干预措施并改善患者护理。
