Trends in bronchopulmonary dysplasia and 15-year evolution in respiratory and hemodynamic management of very premature infants.

Advances in respiratory and haemodynamic management of premature infants in recent years may impact the development of Bronchopulmonary dysplasia (BPD). Our aim was to evaluate trends in BPD incidence in our neonatal unit over the past 15 years and to assess the impact of conservative approach in patent ductus arteriosus (PDA) management on these trends. We conducted an observational study among neonates born before 32 weeks and admitted to BCNatal Hospital Clinic from 2008 to 2022. The cohort was divided into three epochs (2008-2012, 2013-2017, 2018-2022). A total of 1528 preterm infants (687, 476, and 365 in each epoch) were evaluated, out of which 32.4% died or were affected by BPD. The incidence of moderate-severe BPD raised in the last period (15.9%, 17.2%, and 28.5%) and mortality decreased (13.9%, 12.7% and 8.2%). Only infants with a medically treated PDA were included for predictive modelling of death or moderate-severe BPD. The model used multivariable logistic regression and was adjusted for covariates and a propensity score. The number of blood transfusions, use of ventilation and paracetamol treatment for PDA were found to increase the odds of death or moderate-severe BPD. Birthweight, surfactant administration and non-invasive ventilation were found to be protective factors.