165 The “New” Bronchopulmonary Dysplasia. Epidemiological Study on The Euroneonet Database

Abstract

Background: Bronchopulmonary dysplasia (BPD) has classically been related to the use of high oxygen concentrations and mechanical ventilation in infants with respiratory distress syndrome (RDS). However, an increasing number of very low birth weight infants (VLBWI) develop BPD without having acute RDS, which has been termed “new” BPD.Aim: To identify the characteristics of VLBWI who develop this “new ” form of BPD.Methods: This is a multicenter, prospective, longitudinal study of a cohort of 1798 VLBWI born in 2001 and 2002, at one of the 30 Spanish NICU included in EuroNeoNet initiative. The database, including demographic characteristics, risk factors, interventions and outcomes, was searched to identify babies alive at 36 weeks PMA (n=1549). BPD was diagnosed (need of oxygen at 36 PMA) in 221(14%) babies, 32 of who did not have RDS. An univariate and logistic regression analysis was used to asses the risk factors for BPDResults: In comparison to the classical BPD, babies with the “new” BPD were more mature, had a higher birthweight, needed less resuscitation manoeuvres and respiratory support, had a lower incidence of PCA, but a higher one of early sepsis (7.4 vs. 12.5%) and NEC (6.9 vs. 21.9 %). Multifactorial analysis in infants without RDS (n=804), showed an increased risk for BPD related to use of CPAP (OR 3.6; 95% IC 1.5– 8.8) and mechanical ventilation (4.8; 1.9–11.8), and to the presence of both, early sepsis (9.1; 1.9– 42.4) and late sepsis (4.8; IC 2–11.1). However, in patients with RDS (n=745) we showed an increased risk related to CPAP, mechanical ventilation, late sepsis and PDA (1.7, 1.1–2.6), but not with early onset sepsis.Conclusion: As previously reported (1), we showed risk factors of developing DBP in infants with and without RDS are CPAP, mechanical ventilation, and late sepsis. Nevertheless, in babies without RDS, BDP is associated with early sepsis, and in those with RDS with PDA. Despite the small number of patients without RDS who developed BPD in our cohort, the higher incidence of early sepsis and NEC point out toward prenatal factors related to fetal inflammatory disease (2).