Risk Factor Analysis Of Bronchopulmonary Dysplasia In Very Low And Ultra Low Birth Weight Infants

Objective:Through retrospective analysis of clinical data,to explore the risk factors of bronchopulmonary dysplasia(BPD)and its severity for very low(VLBWI)and ultra-low birth weight infants(ELBWI).To provide a theoretical basis for the occurrence of BPD and the influence of its severity.To provide a basis for its prevention and treatment,thereby maximizing the quality of life of very low and ultra-low birth weight infants.Methods:Collected and retrospectively analyzed the clinical data of 175 extremely low and ultra-low birth weight infants admitted and diagnosed in our hospital’s neonatal treatment center(NICU)from 2015.11.1 to 2019.10.31 that met the inclusion criteria.1)Divided into BPD group and non-BPD group according to the oxygen supply time(FiO2 greater than 21%)≥28d,compared the relationship with BPD between different birth weight and gestational age(GA)and the number of blood transfusion;2)analyzed non-BPD Group and BPD group of pregnant women,the prenatal basic conditions,the general characteristics of the newborn,the hospital admission test results and treatment status,the incidence of basic complications of children,to discuss the risk factor of BPD in the extremely low,ultra-low birth weight infants;3)Divided in to moderate to severe group and mild group according to the diagnostic criteria of BPD degree,comparing clinical data of pregnant women,neonatal basic characteristics and complication between the two groups,and obtained the development of extremely low and ultra-low birth weight infants Independent risk factors for moderate to severe BPD.Result:1.During the study period,there were 650 premature infants hospitalized in our hospital,175 cases that met the inclusion criteria,107 males and 68 females,including 11 cases of ultra-low birth weight infants and 164 cases of very low birth weight infants,of which 116 cases of BPD did not occur,59 cases of BPD occurred,32 cases of moderate to severe,27 cases of mild BPD,the proportion of moderate to severe BPD was higher than mild,In the premature infants,ultra-low birth weight infants and very low birth weight infants,The BPD incidence rates is 9%,55%and32%respectively,with the increase in gestational age and body weight,the incidence of BPD decreased significantly,and the incidence of BPD increased with the number of red blood cell transfusions.There was a statistically significant difference in the occurrence of BPD between the different birth weight and gestational age(GA)and the number of blood transfusion,with the highest incidence of BPD at birth weight≤1000 g,birth gestational age≤28 w,and red blood cell transfusion times≥10times.2.Analysis of related influencing factors of BPD showed:gestational age at birth,birth weight,white blood cell count at admission>20*10~9/L,mechanical ventilation time>7d,red blood cell transfusion times,twins,neonatal asphyxia,Neonatal respiratory distress syndrome(NRDS),Patent ductus arteriosus(PDA),pneumonia,cholestasis,frequent apnea,and the use of invasive mechanical ventilation were significantly different between the BPD group and the non-BPD group(P<0.05),which proved to be related to BPD.Multivariate logistic regression analysis showed that:low gestational age,white blood cell count at admission>20*10~9/L,frequent apnea,mechanical ventilation time>7d,and patent ductus arteriosus were independent risk factors for BPD.3.Univariate analysis showed that:There were significant differences between in mild BPD group and moderate to severe BPD group at prenatal infection,gestational age,birth weight,invasive mechanical ventilation,mechanical ventilation time>7days,use of PICC,neonatal asphyxia,cholestasis,coagulopathy,with statistical significance(P<0.05),which was related to the severity of BPD,and the lower the gestational age and the lower the birth weight,the heavier the BPD.Multivariate logistic regression results indicate that low gestational age,neonatal asphyxia,and cholestasis are independent risk factors for the severity of BPD.Conclusions:1.The occurrence of BPD is mainly concentrated in premature infants with gestational age≤28 w and birth weight≤1000g.With the decrease of body weight and gestational age,the incidence and severity of BPD increased,and the higher the incidence of BPD due to the increase in the number of red blood cell transfusions.2.The occurrence of BPD in very low and ultra-low birth weight infants is related to multiple factors,low Gestational age,white blood cell count at admission>20*10~9/L,frequent apnea,mechanical ventilation time>7d,and patent ductus arteriosus are significant independent risk factors for BPD.3.The impact on the development of BPD in very low and ultra low birth weight Moderate to severe factors are involved in many factors,including low gestational age,neonatal asphyxia,and cholestasis are independent risk factors for the severity of BPD.