High Risk Factors Of Bronchopulmonary Dysplasia And Its Severity In Premature Infants

Background and Objectives:With the continuous improvement of medical and nursing care,the survival rate of premature babies continues to increase,accompanied by an increase in the incidence of bronchopulmonary dysplasia(BPD).BPD is a common respiratory complication of premature infants,and its occurrence is related to a variety of factors,and the lung function of some surviving children is significantly reduced compared with normal children and even has sequelae such as cor pulmonale and cerebral palsy.Therefore,it is very important to actively look for high-risk factors for the occurrence of BPD for prevention and control.This study retrospectively collects the clinical data of gestational-age ≤ 34 weeks preterm infants admitted to nicu in our hospital,analyzes the risk factors of BPD and its severity,provides a theoretical basis for guiding the clinical prevention of BPD occurrence,and improves the long-term quality of life of preterm infants by reducing the incidence of BPD.Methods:Preterm infants aged ≤ 34 weeks admitted to the neonatal intensive care unit(NICU)of Huaihe Hospital of Henan University from 2019 to 2021 were collected as research subjects for retrospective research.According to whether BPD occurs,the children are divided into BPD groups and non-BPD groups,and the general situation of the mother,the examination results after the child’s admission,the child’s primary disease and complications during hospitalization,the general situation and treatment of the child are statistically analyzed,and the high risk factors for the development of BPD in preterm infants with a gestational age of ≤ 34 weeks are discussed.According to the correction of gestational age of 36 weeks or the oxygen concentration required to maintain normal oxygen saturation at the time of discharge,the prenatal situation of the pregnant mother,the examination results after the admission of the child,the child’s underlying disease and complications during hospitalization,the general situation and treatment of the child,and the high risk factors affecting the severity of BPD in the child were discussed.Results:1.A total of 209 premature infants with gestational age ≤34 weeks were admitted to our center,among which 12 were seriously ill and their families gave up treatment,8 were transferred to other hospitals for treatment,and 14 were hospitalized for less than 28 days.A total of 175 premature infants met the inclusion criteria,including 90 males and 85 females,and 60(34.2%)developed BPD.There were 33males(55%)and 27 females(45%)with a mean birth weight of 1229.3±364.2g and a mean gestational age of 29.99±1.73 weeks.There were 115 children without BPD,including 57 males(49.5%)and 58 females(50.4%),with an average birth weight of 1712.6±446.6g and an average gestational age of 32.22±1.23 weeks.There were 28 mild BPD patients and 32 moderate severe BPD patients.The incidence of BPD decreased with the increase of gestational age and body weight.2.There were no significant differences in preeclampsia,intrauterine distress,placental abruption,twin fetus,placenta previa,or prenatal hormone use between BPD and non-BPD groups(P> 0.05).There was statistical difference between BPD group and non-BPD group(P< 0.05),and premature rupture of membranes is an independent risk factor for BPD in premature infants.3.AOP,NRDS,PDA,children with neonatal pneumonia,neonatal sepsis,birth weight,gestational age,hospital 1 week minimum value hemoglobin(HGB),was hospitalized at 1 week of supply of heat(heat),atomization time,parenteral nutrition,caffeine use time,mechanical ventilation time,use of pig lung phospholipids injection and use a number 2 times,1 minute or Ap Gar score ≤7.PH at admission was a risk factor for BPD(P< 0.05),neonatal pulmonary hemorrhage,gender,PCO2,PO2,HCO-3 at admission were not statistically significant(P>0.05).Multivariate Logistic regression analysis showed that caloric supply,intravenous nutrition time,mechanical ventilation time,AOP,neonatal pneumonia,neonatal sepsis,Apgar score ≤7 in 1 minute and premature rupture of membranes were independent risk factors for BPD at 1 week after admission.4.Neonatal pulmonary hemorrhage,neonatal pneumonia,porcine lung phospholipid injection ≥2times,parenteral nutrition duration,mechanical ventilation duration were the risk factors for the severity of BPD(P< 0.05),multivariate Logistic regression analysis showed that mechanical ventilation time was an independent risk factor for moderate to severe BPD.Conclusion:1.With the increase of body weight and gestational age,the incidence of BPD decreased gradually.The prevalence of BPD was 88.9% at 30 weeks and 53.4% at polar birth weight in premature infants.2.There are various factors influencing the development of BPD in premature infants,among which,premature rupture of membranes,AOP,neonatal pneumonia,neonatal sepsis,parenteral nutrition duration,mechanical ventilation duration,1 minute Apgar score ≤ 7,and calorie supply at 1 week are independent risk factors for BPD.3.Duration of mechanical ventilation is an independent risk factor for the severity of BPD.