Analysis of clinical characteristics and risk factors of bronchopulmonary dysplasia in newborns of different gestational ages

doi:10.3969/j.issn.1674-490X.2022.05.003

Abstract

Abstract: Objective To investigate the clinical characteristics and risk factors of bronchopulmonary dysplasia(BPD)at different gestational ages, and provide targeted diagnosis and treatment guidance for children with BPD at different gestational ages. Methods The clinical data of 241 premature infants diagnosed as BPD in neonatal intensive care unit of Affiliated Hospital of Hebei University from February 2017 to February 2022 were collected and divided into three groups according to gestational age: gestational age <30 weeks group(105 cases), gestational age 30-32 weeks group(83 cases), and gestational age >32 weeks group(53 cases). The differences in general situation, maternal risk factors, treatment and complications among the three groups were compared. Results Among premature infants with BPD, there was no significant difference in gender and delivery mode among different gestational age groups(P>0.05), and the difference in birth weight was statistically significant(P<0.05). There was no significant difference in the scores of premature rupture of membranes, placental abnormalities and Apgar score among the maternal risk factors(P>0.05). There was significant difference in the scores of preeclampsia, gestational diabetes mellitus, prenatal hormone application and chorioamnionitis(P<0.05). There was no significant difference in the application rate of glucocorticoid and caffeine citrate after birth(P>0.05). There were significant differences in mechanical ventilation time, oxygen therapy time and hospitalization time(P<0.05). There was no significant difference in neonatal respiratory distress syndrome(NRDS)and sepsis among the complications(P>0.05). There were significant differences in pneumonia, intracranial hemorrhage(ICH)and periventricular leukomalacia(PVL)(P<0.05). Conclusion There are differences in clinical characteristics and risk factors among children with BPD of different gestational ages. Effective diagnosis and treatment should be carried out according to different gestational ages to avoid long-term mechanical ventilation and actively control the pulmonary infection that may be caused by mechanical ventilation, which can reduce the occurrence of the disease.

Key words: premature infants, mechanical ventilation, bronchopulmonary dysplasia, gestational age, clinical features

CLC Number:

YANG Dongfei, ZHONG Xiaoyi, XIANG Jingjing, LI Shaohua, WANG Yu. Analysis of clinical characteristics and risk factors of bronchopulmonary dysplasia in newborns of different gestational ages[J]. Journal of Hebei Medical College for Continuing Education, 2022, 39(5): 13-18.

References

[1] SIFFEL C, KISTLER K D, LEWIS J F M, et al. Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review[J]. J Matern Fetal Neonatal Med, 2021, 34(11): 1721-1731. DOI: 10.1080/14767058.2019.1646240.
[2] 早产儿支气管肺发育不良调查协作组.早产儿支气管肺发育不良发生率及高危因素的多中心回顾调查分析[J].中华儿科杂志, 2011, 49(9): 655-662. DOI: 10.3760/cma.j.issn.0578-1310.2011.09.004.
[3] ALVIRA C M. Aberrant pulmonary vascular growth and remodeling in bronchopulmonary dysplasia[J]. Front Med(Lausanne), 2016, 3: 21. DOI: 10.3389/fmed.2016.00021.
[4] 梁莹莹,邹卉,韩梅盈,等.不同分度早产儿支气管肺发育不良临床特点比较[J].山东医药, 2016, 56(1): 52-54. DOI: 10.3969/j.issn.1002-266X.2016.01.019.
[5] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].5版.北京:人民卫生出版社,2018: 596-597.
[6] JOBE A H, ABMAN S H. Bronchopulmonary dysplasia: a continuum of lung disease from the fetus to the adult[J]. Am J Respir Crit Care Med, 2019, 200(6): 659-660. DOI: 10.1164/rccm.201904-0875ED.
[7] BANCALARI E, CLAURE N, SOSENKO I R S. Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition[J]. Semin Neonatol, 2003, 8(1): 63-71. DOI: 10.1016/s1084-2756(02)00192-6.
[8] 廖静,刘兆娥.超低出生体质量儿支气管肺发育不良的危险因素分析[J].重庆医学, 2017, 46(26): 3658-3660. DOI: 10.3969/j.issn.1671-8348.2017.26.020.
[9] VILLAMOR-MARTINEZ E, ÁLVAREZ-FUENTE M, GHAZI A M T, et al. Association of chorioamnionitis with bronchopulmonary dysplasia among preterm infants: a systematic review, meta-analysis, and metaregression[J]. JAMA Netw Open, 2019, 2(11): e1914611. DOI: 10.1001/jamanetworkopen.2019.14611.
[10] 林慈丽,盛苗苗,卢赛丹,等.早产儿支气管肺发育不良危险因素研究[J].中国预防医学杂志, 2018, 19(12): 928-932. DOI: 10.16506/j.1009-6639.2018.12.012.
[11] DRAVET-GOUNOT P, TORCHIN H, GOFFINET F, et al. Bronchopulmonary dysplasia in neonates born to mothers with preeclampsia: impact of small for gestational age[J]. PLoS One, 2018, 13(9): e0204498. DOI: 10.1371/journal.pone.0204498.
[12] 朱艳可,孙媛媛,缪克凡,等.早产儿支气管肺发育不良影响因素分析[J].预防医学, 2019, 31(10): 1051-1053. DOI: 10.19485/j.cnki.issn2096-5087.2019.10.020.
[13] 莫艳,陈玉君,韦秋芬,等.极低出生体重早产儿支气管肺发育不良高危因素分析[J].中华妇幼临床医学杂志(电子版), 2019, 15(3): 320-327. DOI: 10.3877/cma.j.issn.1673-5250.2019.03.013.
[14] 赵伟明,马俐.咖啡因对支气管肺发育不良的预防作用研究进展[J].临床儿科杂志, 2019, 37(7): 553-556. DOI: 10.3969/j.issn.1000-3606.2019.07.018.
[15] 李文丽,徐发林,牛铭,等.不同程度支气管肺发育不良早产儿的临床特征及预后分析[J].中国当代儿科杂志, 2018, 20(4): 261-266. DOI: 10.7499/j.issn.1008-8830.2018.04.002.
[16] PAPAGIANIS P C, PILLOW J J, MOSS T J. Bronchopulmonary dysplasia: pathophysiology and potential anti-inflammatory therapies[J]. Paediatr Respir Rev, 2019, 30: 34-41. DOI: 10.1016/j.prrv.2018.07.007.
[17] CHEONG J L Y, DOYLE L W. An update on pulmonary and neurodevelopmental outcomes of bronchopulmonary dysplasia[J]. Semin Perinatol, 2018, 42(7): 478-484. DOI: 10.1053/j.semperi.2018.09.013.
[18] GALINSKY R, LEAR C A, DEAN J M, et al. Complex interactions between hypoxia-ischemia and inflammation in preterm brain injury[J]. Dev Med Child Neurol, 2018, 60(2): 126-133. DOI: 10.1111/dmcn.13629.