Bronchopulmonary dysplasia risk prediction in prematurely born children

Abstract

Bronchopulmonary dysplasia (BPD) is one of the most frequent outcomes of prematurity. Relatively late diagnosis and development of formidable complications that can affect the quality of life in adulthood, determine the need for early BPD prognosis for the timely appointment of effective therapy. Purpose - identification of informatively significant clinical and anamnestic risk factors of BPD based on retrospective analysis and mathematical model creation for the prediction of chronic respiratory disease risk development in prematurely born children. Materials and methods. A retrospective analysis of the medical histories of 280 prematurely born children who were treated in neonatal units was conducted. With the help of sequential Wald analysis, 53 clinical and anamnestic indicators were analyzed, for each of them the relative risk (RR) and diagnostic coefficient (DC) were calculated. Results. Significant, prognostically unfavorable factors for BPD development are gestational age ≤28 weeks (RR=20.30); birthweight ≤1500 g (RR=3.08); duration of non-invasive combined respiratory support over 18 days (RR=3.74); Apgar score 1-3 at the first minute (RR=4.69) and 4-6 at the fifth minute of life (RR=4.19); newborn anemia (RR=3.12); invasive artificial lung ventilation for more than 13 days (RR=5.12). The probability of BPD increases substantially with the presence of retinopathy of the II and III degrees (RR=16.4 and RR=10.15, respectively). Interestingly, breastfeeding markedly prevented BPD development (RR=0.29). Furthermore, a mathematical model is represented to determine BLD development prediction and to diagnose this disease. Conclusions. High validity indicators and ease of use of the mathematical model for the BPD development prediction in prematurely born children make it possible to recommend it in the practice of neonatologists and pediatricians. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.