Risk factors for the development of bronchopulmonary dysplasia: a case-control study

Background

Advances in neonatal care over the past decades have meant that an increasing number of very premature infants survive today than in years past. One of the main factors contributing to the survival of these infants is development in ventilatory support. However, this has lead to lung injury and an increase in the incidence of bronchopulmonary dysplasia (BDP).

Methods

A case-control study was conducted at the National Institute of Perinatology Neonatal Intensive Care Unit in Mexico City, Mexico to evaluate the risk factors associated with the development of BPD in premature infants requiring ventilatory support within the first days of life for respiratory failure. Twenty two cases and 22 control premature infants admitted to the Neonatal Unit requiring assisted ventilation and that survived for more than 28 days were included. The neonatal and maternal risk factors that were considered for analysis were the following; mode of delivery, antenatal steroids, gestational age, birth weight, Apgar scores, sepsis, patent ductus arteriosus, and ventilation parameters.

Results

Factors associated with the development of BPD were late sepsis (OR 7.29, 95% CI 1.61–35.8, p=0.002), and two or more episodes of sepsis (OR 7.60, 95% CI 1.46–44.6, p=0.004). Other risk factors were low birth weight and younger gestational age at birth.

Conclusions

Similar to what has been reported by other investigators in developed countries, our study showed that neonatal sepsis, low birth weight, and gestational age were associated with BPD in our patients.

Key words: Chronic lung disease, Sepsis, Risk factors, Patent ductus arteriosus, Bronchopulmonary dysplasia, Respiratory distress syndrome