Therelationship Between Early Antibiotic Use And The Occurrence And Severity Of BPD In Preterm Infants:A Prospective Cohort Study

Objective: To investigate the relationship between the use of antibiotics in early postnatal period and the occurrence and severity of BPD in preterm infants.Methods: We performed prospective cohort study at the Children’s Hospital of Chongqing Medical University from January 1,2019 to December 31,2020,and collected the clinical data of preterm infants with gestational age less than 32 weeks and admitted within 24 hours after birth.According to the use time of antibiotics in 2 weeks after birth,preterm infants were divided into three groups: group A(0-3 days),group B(4-7 days)and group C(8-14 days).Univariate analysis,propensity score matching and logistic regression were used to analyze the relationship between antibiotic use and the occurrence and severity of BPD.Then according to the statistical results,preterm infants were divided into antibiotic use > 7 days group and antibiotic use ≤ 7 days group and we analyzed the relationship between antibiotic use for more than 7 days and the occurrence and severity of BPD.Results: In this study,308 cases of preterm infants were included:including 62 cases in group A,14 cases of mild BPD,24 cases of moderate to severe BPD;88 cases in group B,13 cases of mild BPD,37 cases of moderate to severe BPD;158 cases in group C,20 cases of mild BPD,119 cases of moderate to severe BPD.Logistic regression analysis showed that there was no significant difference in the incidence of BPD between group A and group B(p=0.26,OR=0.55,95%CI:0.20-1.54);There was significant difference in the incidence of BPD between group A and group C(p=0.02,OR=5.17,95%CI:1.37-19.57);There was significant difference in the incidence of BPD between group B and group C(p<0.01,OR=4.77,95%CI:1.90-11.93).Subgroup analysis showed that there was no significant difference in the incidence of moderate to severe BPD between group A and group B(p=0.97,OR=0.98,95%CI:0.32-3.00);There was significant difference in the incidence of moderate to severe BPD between group A and group C(p<0.01,OR=7.49,95%CI:1.88-29.83);There were significant differences in the incidence of moderate to severe BPD(p=0.03,OR=2.63,95%CI:1.13-6.12)between group B and group C.Further analysis showed that antibiotic use for more than 7 days was associated with the incidence of BPD(p﹤0.01,OR=3.44,95%CI:1.40-8.49),and increased the incidence of moderate to severe BPD(p﹤0.01,OR=3.55,95%CI:1.51-8.32).Conclusion: In preterm infants with gestational age < 32 weeks,antibiotic use for more than 7 days within 2 weeks after birth increases the incidence of BPD,which may be related to the severity of BPD.