Abstract Ref Number = APCP273
RISK FACTORS OF BRONCHOPULMONARY DYSPLASIA IN PRETERM INFANTS A STUDY FROM HARAPAN KITA CHILDREN AND WOMEN'S HOSPITAL INDONESIA
Ferry Liwang,Dina Amalia Pratiwi,M Reza Syahli,Octafika Hairlina Ayu Latifa,Tommy Gunardi Santoso,Toto Wisnu Hendrarto
Assistant Neonatology Working Group Indonesia Pediatric Society Perinatology Department, Harapan Kita Children and Womens Hospital
Background : Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in preterm infants who still require mechanical ventilation and oxygen therapy at 36 weeks’ postmenstrual age or discharge to home for infants < 32 weeks or > 28 days but < 56 days’ postnatal age or discharge to home for infants ? 32 weeks. BPD has still been the most prevalent long-term complication in preterm infants associated with prolonged hospital stay, poor growth, and increased risk for neurodevelopmental delay. Identifying the risk factors of BPD may guide the prevention and treatment strategies. However, controversies still exist to the risk of the developing BPD. Therefore, this study aims to determine the risk factors of BPD.
Material : Over 2-year period, 208 preterm infants at Level III Neonatal Intensive Care Unit Harapan Kita Children and Women’s Hospital were enrolled in this retrospective cohort study. Details including characteristics and risk factors (antenatal, perinatal, and postnatal) were collected. All risk factors of the infants with and without BPD were analyzed independently, followed by multivariate analysis.
Results : The median gestational age and birth weight of all infants were 31 (range, 24–36) weeks, and 1405 (range, 425–3960) gram, respectively. BPD was diagnosed in 23.1% of all infants. Gestational age < 32 weeks, cesarean section delivery, prolonged supplemental oxygen and mechanical ventilation, PRC transfusion, fluid overload, late-onset sepsis, necrotizing enterocolitis (NEC), anemia, and thrombocytopenia were risk factors for BPD, while surfactant and postnatal steroid were protective factors (P <0.05). Multivariate logistic regression revealed that duration of supplemental oxygen (OR 7.397, P <0.001), duration of mechanical ventilation (OR 10.442, P < 0.05), PRC transfusion (OR 4.458, P <0.05), and NEC (OR 3.945, P = 0.002) played crucial roles in BPD.
Conclusions : This study suggests that prolonged supplemental oxygen and mechanical ventilation are the most important risk factors for BPD.
Keywords: bronchopulmonary dysplasia preterm infants risk factors