Manutenção do estado comportamental para início da alimentação oral de prematuro com displasia broncopulmonar

Background: Bronchopulmonary dysplasia (BPD) is a common severe respiratory problem in premature infants, and imaging information has important reference value for its diagnosis. Recently, lung ultrasonography (LUS) has been successfully used for the diagnosis and differential diagnosis of neonatal lung diseases (NLDs), but the study of the diagnosis of BPD is still rare. Objectives: The purpose of this study was to investigate the ultrasonographic characteristics of BPD and its value for the diagnosis and differential diagnosis of premature infants’ BPD. Methods: From January 2015 to December 2019, 25 premature infants diagnosed with early-stage BPD and 32 infants diagnosed with late-stage BPD according to their medical history, clinical manifestation, and chest X-ray were included in this study. The LUS examinations were performed on each infant. The LUS findings were recorded and compared with those of 40 premature infants without lung diseases. Results: The gestational age of 25 early-stage BPD infants was 26+1 – 31+6 weeks, and their birth weight was between 730 and 1,810 g. The gestational age of 32 late-stage BPD infants was 26 - 32 weeks, and their birth weight was 750 - 1,760 g. The gestational age of 40 control infants was 25+6 - 32+1 weeks, and their birth weight was 810 - 2,050 g. There was no difference in the proportion of primary lung diseases (including RDS, TTN, pneumonia, etc.) between the three groups. The proportions of infants receiving invasive and/or non-invasive respiratory support at admission in the three groups of early BPD, late BPD, and normal control were 20/25 (80.0%), 26/32 (81.2%), and 33/40 (77.5%), respectively, with no significant difference (P > 0.05). The mechanical ventilation duration over one week in three groups was 15/20 (75%), 21/26 (80.7%), and 24/33 (72.7%), respectively, with no significant difference (P > 0.05). Nonspecific pleural line abnormalities were seen in all early and late BPD patients (100%), alveolar-interstitial syndrome (AIS) in 16 cases (64%) of early BPD and 32 cases of late BPD infants (100%), pleural insect erosion-like change (PIE-like change) in two cases of early-stage BPD infants (8.0%) and 20 cases (62.5%) of late-stage BPD infants, and air vesicle signs (AVS) only in 17 cases of late-stage BPD infants. The sensitivity and specificity of PIE-like change for the diagnosis of late-stage BPD were 62.5% and 92.0%, respectively, and the sensitivity and specificity of AVS for the diagnosis of late-stage BPD were 53.1 and 100%, respectively. Conclusions: Lung ultrasonography is not specific for the diagnosis of early-stage BPD, but has a high reference value and specificity for the diagnosis of late-stage BPD when combined with obvious pulmonary fibrosis and pulmonary vesicle formation, which is mainly manifested by AIS, PIE-like change, and AVS.

AimsTo describe the incidence, risk factors and short-term hospital outcomes for varying severity of BPD. This would help us in designing local quality improvement project.MethodsWe conducted a retrospective cohort study...

To know the effect of caffeine therapy on infant lung function in preterm infants with a gestational age less than 31 weeks. Forced vital capacity (FVC), forced expiratory volume at 0.5 seconds (FEV0.5 ), and forced expiratory flows were measured by raised volume rapid thoracoabdominal compression technique; functional residual capacity was measured by plethysmography (FRCpleth ). Compliance of the respiratory system was measured by a single interruption technique (Crs). The Student t test was used to compare lung function measurements between the two groups: treated versus nontreated with caffeine. A multivariate analysis was carried out considering each and every lung function parameter (z-score) as the dependent variable; and gender, gestational age, birth weight (z-score), corrected age, invasive mechanical ventilation (yes/no), and bronchopulmonary dysplasia (BPD) diagnosis (yes/no) as independent ones. Additionally, stratified analyses by BPD diagnosis were performed. The multivariate analysis showed significant higher z-scores of FVC and FEV0.5 in preterm infants treated with caffeine (P = .004 and P = .024, respectively). This result only being significant in the group of non-BPD infants (P = .021 and P = .042), after stratifying by BPD diagnosis. Differences were not found in z-scores of FEV0.5/FVC, FEF75, FEF25-75, FRCpleth, nor Crs. Lung function (FVC and FEV0.5 ) is improved in infants born under 31 weeks of gestation when treated with caffeine. This improvement is driven by the group of infants who did not suffer from BPD. Overall, our results show that there is an early beneficial effect of caffeine treatment in infant lung function.

Objective To study the early physical growth pattern, catch-up growth situation, and the influencing factors of early growth in small for gestational age (SGA) preterm infants. Method Our study was a single center, retrospective study. Criteria for infant inclusion were prematurity, SGA (birth weight less than the 10th percentile of related gender and gestational week, according to Fenton curve 2013), born between January 2012 to October 2015, admitted to our neonatal intensive care unit (NICU) within 24 h after birth, hospitalization more than 7 days, and discharged with complete oral feeding. Corrected age (CA) was used to evaluate growth. According to our follow up plan, anthropometric data (weight, length, head circumference) were collected at corrected full term (40±4 weeks), CA (3±1.5) months and CA (6±1.5) months. Catch-up growth was defined as ΔZ greater than 0.67 compared with that at birth, successful catch-up was defined as anthropometric data higher than 10th percentile in target population. The characteristics and influencing factors were compared between infants with and without catch-up growth. Result Eighty-one SGA preterm infants were involved, 45 boys and 36 girls. The average gestational age was (34.6±1.7) weeks, birth weight was (1 617±348) g, birth length was (41.0±3.2) cm and head circumference was (29.7±2.0) cm. At corrected gestational age (40±4) weeks, CA (3±1.5) months and CA (6±1.5) months, follow-up rate was 86.4%, 66.7% and 58.0%; catch-up growth in weight was 32.9%, 55.6% and 66.0%; successful catch-up growth in weight was 52.9%, 64.8% and 66.0%. At CA (40±4) weeks, there were more boys, sooner recover birth weight, and less patent ductus arteriosus (PDA) in catch-up infants (P<0.05). At CA (3±1.5) months, catch-up infants had large gestational age, and they were longer at discharge, shorter hospital stay, less PDA, and greater body weight at CA 40 weeks, the difference was statistically significant (P<0.05). At CA (6±1.5) months, there were difference in hospitalization days, percentile of body weight at CA 40 weeks and percentile of all three anthropometrics at CA (3±1.5) months between catch-up and no catch-up growth infants (P<0.05). Multiple factor analysis showed that percentile of weight at CA 3 months was the independent risk factor of catch-up growth in weight at CA 6 months (P=0.002, OR=1.221, 95%CI 1.076~1.385). For every 5 percentile increase in body weight percentile at CA (3±1.5) months of age, the likelihood of complete body weight catch-up growth at CA (6±1.5) months increased 2.965 times (95%CI 1.480~5.942). Conclusion Both weight and length of SGA preterm infants showed a trend of rapid gain between corrected gestational age (40±4) weeks to CA (3±1.5) months. The factors that influencing the completion of catch-up growth are different at different age. The weight, length, and head circumference percentile at CA about 3 months are good predictors of growth pattern and situation at CA 6 months for the SGA preterm infants. Key words: Infant, premature; Infant, small for gestational age; Catch-up growth; Risk factors

Bronchopulmonary dysplasia (BPD) is the most common respiratory complication in preterm infants, and there is a lag in the diagnosis of BPD. Inflammation is a vital pathogenic factor for BPD; we aim to evaluate the predictive and diagnostic values of systemic inflammatory indices in BPD. Between 1 January 2019 and 31 May 2023, the clinical data of 122 premature infants with a gestational age of <32 weeks in the Department of Neonatology, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, were retrospectively collected and classified into non-BPD (n = 72) and BPD (n = 50) groups based on the National Institute of Child Health and Human Development 2018 criteria. To compare the general characteristics of each group, we identified the independent risk variables for BPD using multivariate logistic regression analysis, compared the systemic inflammatory indices at birth, 72 h, 1 week, 2 weeks, and 36 weeks postmenstrual age (PMA), and constructed the receiver operating characteristic curves of neutrophil-to-lymphocyte ratio (NLR) diagnosis of BPD at different time points. ① The independent risk factors for BPD in preterm infants were birth weight, small for gestational age, and days of oxygen therapy (all p < 0.05). ② At 72 h and 1 week after birth, the serum NLR of the BPD group was higher than for the non-BPD group (p < 0.05). Furthermore, the neutrophil count (N), NLR, monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index, systemic inflammation response index (SIRI), and pan-immune-inflammation value of infants with BPD were higher than the non-BPD group at 3 weeks after birth (p < 0.05). Moreover, at 36 weeks of PMA, the serum N, NLR, MLR, and SIRI of BPD infants were higher than those of non-BPD infants (p < 0.05). ③ The NLR of infants with and without BPD gradually increased after birth, reaching a peak at 72 h and 1 week, respectively. At 3 weeks postnatal, the NLR had the highest predictive power for BPD, with an area under the curve (AUC) of 0.717 (p < 0.001); the sensitivity was 56% and specificity was 86.1%. In addition, the NLR at 36 weeks of PMA exhibited some diagnostic value for BPD. The AUC was 0.693 (p < 0.001), the sensitivity was 54%, and specificity was 83.3%. At 3 weeks after birth and 36 weeks of PMA, some systemic inflammation indices (like N, NLR, SIRI) of preterm infants with BPD have specific predictive and diagnostic values; these indices may help the management of high-risk preterm infants with BPD.

Introduction: Lower oxygen saturation targets in preterm infants have been associated with decreased incidence of bronchopulmonary dysplasia (BPD) but increased risk of pulmonary hypertension (PH). Studies have shown that targets of &lt;90% are associated with higher incidence of PH, however data on the optimal saturation target &gt;90% are lacking. In this study, we compared the rate of BPD and PH in two cohorts with saturation targets of 94-98% and 92-97%. We hypothesized that BPD rate would be lower and PH rate would be unchanged at the lower saturation target. Methods: We performed a retrospective cohort study comparing PH and BPD rates among two cohorts of infants born at ≤32 weeks gestation at Brigham and Women’s Hospital: cohort 1 with saturation target of 94-98% (n = 129, July 2017-July 2018), cohort 2 with saturation target of 92-97% (n = 124, July 2018-July 2019). PH was defined by echocardiographic evidence of systolic septal flattening or right ventricular pressure ≥35 mmHg (estimated by tricuspid regurgitant jet velocity or shunt velocity) at gestational age (GA) ≥36 weeks. Comparisons between groups were carried out by Chi-square test, t-test, and multivariable logistic regression. Results: Subjects had a GA of 23-32 weeks; 46% were female. Groups did not differ with respect to GA, sex, or birth weight. There was no difference in rate of PH (2.4% vs. 4.2%, p = 0.12) or BPD (25% vs. 20%, p = 0.31) between cohort 1 and cohort 2. Other clinical parameters were not different between groups, including presence of patent ductus arteriosus, presence of atrial septal defect, use of diuretics, or use of steroids. After controlling for GA, birth weight, sex, and diagnosis of BPD using logistic regression, there was no difference in rate of PH between groups (p = 0.47), but there was a positive association of BPD with PH (OR 3.45; 95% CI, 1.18-10.09; p = 0.02). Conclusions: A lower oxygen saturation target was not associated with a higher rate of PH or lower rate of BPD in preterm infants. The overall rate of PH was much lower than rates previously reported at saturation targets &lt;90%. Given our low incidence of PH, and the lack of a significant difference in rate of PH between groups, a saturation target of 92-97% may be safe while also minimizing need for supplemental oxygen in this population.

Objective To analyze the changes in blood metabolites in premature infants with bronchopulmonary dysplasia (BPD) within 36 h and in the 3rd week after birth in order to find new biomarkers for diagnosis of BPD. Methods The BPD group included 20 premature infants (<32 gestational weeks) hospitalized in the Neonatal Intensive Care Unit (NICU) of the Sixth Affiliated Hospital of Sun Yat-sen University and diagnosed with BPD from January 2014 to October 2016. Another 20 non-BPD premature infants with similar gestational age (within one week) who were admitted during the same period were enrolled in the control group. Blood samples of both groups were collected within 36 h and in the 3rd week after birth. Liquid chromatography-tandem mass spectrometry was used to detect blood metabolites and the obtained data were subjected to metabolomics analysis using orthogonal partial least squares discriminant analysis. Chi-square test (or Fisher's exact test), Mann-Whitney U test or t test was used for statistical analysis. Results (1) Twenty and 11 blood samples were collected within 36 h and in the 3rd week after birth from the BPD and the control group, respectively. Compared with the control group, the interval between premature rupture of membranes and delivery, the average length of hospital stay, non-invasive and invasive mechanical ventilation duration and the total duration of supplemental oxygen during hospitalization in the BPD group were longer [M (P25-P75) or (±s): 13.5 (0.0-98.3) vs 0.0 (0.0-0.0) h, Z=3.049; (66.6±20.5) vs (43.9±9.3) d, t=4.574; 267.0 (199.5-516.1) vs 110.5 (0.0-238.5) h, Z=-3.428; 117.5 (0.0-269.3) vs 0.0 (0.0-72.0) h, Z=-2.785; (1 184.0±386.6) vs (595.9±270.3) h, t=5.576; all P<0.05]. (2) Within 36 h after birth, the levels of glycine, proline, tryptophan and piperamide-C5:1 in the BPD group were decreased obviously compared with those in the control group [(201.59±65.01) vs (290.90±137.56) μmol/L, t=-2.625; 103.55 (72.43-434.57) vs 439.48 (103.80-608.98) μmol/L, Z=-2.245; 29.54 (20.30-41.04) vs 47.42 (29.46-73.57) μmol/L, Z=-2.326; 50.04 (35.29-104.78) vs 95.79 (76.21-129.97) μmol/L, Z=-2.029; all P<0.05]. However, the glutamate level was increased [(224.30±67.40) vs (182.67±40.87) μmol/L, t=2.362, P<0.05]. (3) In the 3rd week after birth, the levels of glycine, proline and tryptophan in the BPD group were lower compared to those in the control group [(185.92±61.51) vs (271.85±115.85) μmol/L, t=-2.177; (39.41±18.22) vs (63.92±17.50) μmol/L, t=-3.217; 90.23 (37.93-146.37) vs 330.15 (47.79-622.90) μmol/L, Z=-2.134; all P<0.05]. However, the ornithine level was higher [(75.09±43.21) vs (39.25±16.53) μmol/L, t=2.569, P<0.05]. Conclusions Glycine, proline and tryptophan in blood are potential biomarkers for early diagnosis of BPD. Key words: Bronchopulmonary dysplasia; Amino acids; Metabolomics; Chromatography, liquid; Tandem mass spectrometry

Rationale: Bronchopulmonary dysplasia (BPD) is a common respiratory outcome in extremely low gestational age newborns (ELGANs), yet its pathogenesis remains poorly understood. Metabolic dysregulation has been attributed to the development of BPD. However, there is a need for larger population-based studies with multiple timepoint assessments to further characterize metabolic changes that are associated with BPD. Objective: We aimed to identify the early changes in the urinary metabolome and metabolic pathways that associate with a diagnosis of BPD at 36 weeks postmenstrual age. Methods: Untargeted metabolomic profiling was performed using UHPLC/MS/MS on urine samples collected at two timepoints between postnatal days 6-14, timepoint 1 (TP1), and 23-30, timepoint 2 (TP2), for 178 BPD cases and 136 BPD controls from two independent studies of ELGANs born &amp;lt; 29 weeks gestational age (TOLSURF, and PROP). Logistic regression was used to compare metabolite levels at each timepoint between BPD cases and BPD controls adjusting for self-reported maternal race, gestational age, birth weight, nutritional source (enteral nutrition (EN) vs. total parenteral nutrition(TPN)), and use of corticosteroids. Comparisons were performed within each study and then combined using a weighted meta-analysis. Pathway enrichment was evaluated using a Fisher's Exact test among characterized metabolites found to associate with BPD at p&amp;lt;0.05. Results: Following quality control, we identified 872 and 909 urinary metabolites that belonged to 88 and 91 different metabolic sub-pathways at TP1 and TP2, respectively. At TP1, we identified 24 metabolites that varied in level by BPD status at p&amp;lt;0.05 that were enriched in the lactoyl amino acid sub-pathway (p = 0.0002, FDR = 0.017). At TP2, the urinary levels of 56 metabolites varied by BPD status at p&amp;lt;0.05 that were enriched in fatty acid metabolism (acylcarnitine, medium chain sub-pathway) (p = 0.001, FDR = 0.087). A total of 2 metabolites were consistently at higher levels in infants who did not develop BPD at both time points at p&amp;lt;0.05 (3-hydroxykynurenine and an uncharacterized metabolite). At TP2, 93% of the metabolites that varied by BPD status were elevated in infants that did not develop BPD (52 out of 56 metabolites [p=5.8x10-7], Figure 1). Sub-analyses by nutritional sources at TP2 revealed 61% and 100% of the differential metabolites having higher levels in No BPD infants on TPN and EN, respectively. Conclusion: Our findings indicate metabolic differences in lactoyl amino acids and in fatty acid metabolism in infants that develop BPD, and an overall reduction in metabolism.

Preventing Postnatal Cytomegalovirus Infection in the Preterm Infant: Should It Be Done, Can It Be Done, and at What Cost?

1. Yvonne E. Vaucher, MD, MPH* 1. *Clinical Professor of Pediatrics, Division of Neonatology, University of California, San Diego, Calif. After completing this article, readers should be able to: 1. Describe the most common cause of chronic lung disease during infancy. 2. Explain the importance of a history of bronchopulmonary dysplasia throughout childhood. 3. Identify infants at high risk for developing bronchopulmonary dysplasia. 4. List the adverse effects associated with postnatal corticosteroids. Despite clinical advances in antepartum, intrapartum, and neonatal care, bronchopulmonary dysplasia (BPD) continues to challenge infants who have been in neonatal intensive care units and their caretakers. BPD is the most common cause of chronic respiratory disease during infancy and remains a major cause of long-term medical, pulmonary, and neurodevelopmental morbidity, increasing the cost of health care and the utilization of medical and educational resources throughout childhood. BPD is a clinical diagnosis, defined by oxygen dependence for a specific period of time after birth and accompanied by characteristic radiographic findings that correspond to anatomic abnormalities. Thus far, a precise physiologic definition of BPD is lacking. As the clinical presentation has evolved over the past 30 years, so has the definition. As originally described by Northway in the 1960s, the diagnosis of classic BPD was based on progressive radiographic changes in preterm infants who were treated for severe respiratory distress syndrome (RDS) immediately after birth and had prolonged ventilator and oxygen dependence. This form of BPD occurred in larger, relatively mature preterm infants, who required treatment with high-pressure mechanical ventilation and high concentrations of oxygen. Although the acute respiratory disease initially improved in these infants, oxygen requirements increased 7 to 10 days after birth and persisted for at least 28 days. The definition of BPD subsequently was modified by Bancalari to include preterm infants who had less severe RDS that initially required short-term mechanical ventilation, but who also developed persistent respiratory symptoms and an oxygen requirement for at least 28 days after birth …

Objective To study the efficacy of the preterm oral feeding assessment scale(POFAS) in evaluating oral feeding capacity in preterm infants of different gestational age. Method Revised POFAS including the preterm oral feeding readiness assessment scale and sucking ability scale was used to dynamically evaluate the oral feeding capacity of the stable preterm infants with corrected gestational age (CGA) ≥32+4 weeks. The ratio of actual oral intake volume to planned feeding volume (A/P) was measured, and the correlation of the POFAS score and A/P ratio was studied using Pearson correlation analysis. The risk factors of the A/P ratio was studied using Logistic regression analysis. The receiveroperating characteristic(ROC) curve was drawn to explore the predictive value of POFAS score for A/P ratio reaching 50%. Result A total of 44 infants (59.1% male) with 158 times of evaluation were enrolled in the study. The gestational age was (30.9±2.1) weeks, and the birth weight was (1 543±478) g. The enteral feeding was started at (31.1±2.0) weeks of CGA, the oral feeding at (33.7±1.4) weeks, and complete oral feeding at (34.9±1.3) weeks. When reaching the same CGA, infants born at earlier gestational age had a smaller A/P ratio. Pearson correlation analysis showed that with CGA>33 weeks, all the indicators can predict the feeding conditions of the infants, the POFAS score was positively correlated with the A/P ratio (P<0.05). The ROC for the POFAS score to predict a 50% A/P ratio was 0.951 (P<0.05), and the cut-off value was 6.5 (sensitivity 93.8%, specificity 83.3%).The POFAS score and sucking ability score were the risk factors of a 50% A/P ratio in preterm infants with 34 weeks CGA. Conclusion Revised POFAS can be effectively used to assess preterm infants′ oral feeding ability, promote oral feeding and early discharge from the hospital. Key words: Breast feeding; Infant, premature; Assessment scale; Oral feeding

Background: Pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) is associated with increased morbidity and mortality. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and decreased levels of amino acid precursors of nitric oxide (NO) have been associated with PH, but have not been studied in infants with PH secondary to BPD. Objective: The aim of this study was to identify a biochemical marker for PH in infants with BPD. Methods: Twenty infants, born at <27 weeks' gestational age (GA) and/or with a birth weight (BW) ≤750 g, who met the criteria for BPD at 36 weeks' corrected GA (CGA) were enrolled in this cross-sectional pilot study. A screening echocardiogram was conducted at 36-38 weeks' CGA and plasma NT-proBNP and amino acid levels were obtained within 1 week of the screening echocardiogram. Results: Five infants (25%) had echocardiographic evidence of PH. GA and BW were not significantly different between the 2 groups (a PH group and a No PH group). NT-proBNP was significantly elevated in the PH group (median 1,650 vs. 520 pg/ml; p = 0.001) but citrulline levels were significantly lower (median 21 vs. 36 μmol/l; p = 0.005). Arginine levels were not significantly different between the groups (median 78 vs. 79 μmol/l; p = 1). Conclusion: NT-proBNP and the NO precursor citrulline may be cost-effective biochemical markers for screening for the presence of PH in preterm infants who have BPD. If validated in a larger study, such biochemical markers may, in part, replace PH screening echocardiograms in these patients.

Pulmonary hypertension (PH) is a known complication of bronchopulmonary dysplasia (BPD). This study aimed to determine the utility of serial N-Terminal pro-Brain Natriuretic Peptide (NTproBNP) levels in the screening of BPD associated PH (BPD-PH) in preterm infants. Infants with birth weight <1500 g and <30 week corrected gestational age (CGA) were followed with serial NTproBNP levels and echocardiograms (ECHO). They were divided into control, BPD and BPD-PH groups. Statistical analyses included repeated measures analysis of variance and receiver operator curve (ROC) generation. Infants in the BPD-PH and BPD group had significantly elevated NTproBNP levels as compared to the control group. ROC curves for NTproBNP at 28 weeks CGA provided a cut-point of 2329 pg/ml and 578.1 pg/ml for detection of BPD-PH and BPD, respectively. NTproBNP appears to be a good screening tool to determine the onset of BPD-PH as early as 28 weeks CGA.

To explore the correlation of urinary cysteinyl leukotriene E4 (CysLTE4) and diagnosis of bronchopulmonary dysplasia (BPD) in premature infants. One hundred and fifty-eight newborn infants were consecutively admitted to the neonatal intensive care units of First Affiliated Hospital of Nanjing Medical University from November 2014 to October 2015.The infants were divided into 3 groups according to the diagnosis on discharge.Sixty-one term infants were classified as having no pulmonary diseases, 52 premature infants were classified as without BPD, and 45 premature infants with BPD were diagnosed at 28 d after birth.Urinary CysLTE4 levels of newborns within 3 days after birth were measured in a blinded way by enzyme- linked immunosorbent assay and were compared among 3 groups, and were evaluated for the diagnostic value and the correlation of gestational age and birth weight.Statistical analysis was performed using correlation analysis, one-way analysis of variance and χ(2) test etc. In infants with BPD, the mean urinary CysLTE4 level was (191.0±29.3) ng/L which significantly higher than the premature group without BPD ((164.1±22.7) ng/L) and term infant group ((151.6±41.9) ng/L, F=18.70, P<0.05). Urinary CysLTE4 level within 3 days of life in newborn inversely correlated with gestational age and birth weight (Pearson=-0.33, -0.38, P<0.01). The area under the curve was 0.78, 95%CI: 0.70-0.86, P<0.01, when cutoff was 187.7 ng/L, with Youden index 0.59, sensitivity 77.8% and specificity 81.4%, respectively. Urinary CysLTE4 level is up-regulated in BPD infants within early days of life which may be a useful biomarker of early diagnoses of BPD.

To identify risk factors and develop an early prediction model for bronchopulmonary dysplasia (BPD) in preterm infants with a gestational age (GA) under 32 weeks. A single-centre, retrospective case-control study. A tertiary neonatal intensive care unit in Fujian Province, China. 762 infants (GA under 32 weeks, survived beyond the corrected GA of 36 weeks) who were hospitalised in our department between January 2018 and December 2023. None. The primary outcome was the diagnosis of BPD at 36 weeks of corrected GA, with diagnostic criteria based on the 2018 criteria established by the National Institute of Child Health and Human Development. A total of 762 infants was enrolled in the study, including 572 in the training cohort, among whom 138 (24.13%) had BPD. Multivariate logistic regression identified the following as independent predictors for BPD development: birth weight (OR=0.997, 95% CI 0.996 to 0.998, p<0.001), chest X-ray score within 24 hours of birth (OR=1.777, 95% CI 1.253 to 2.521, p=0.001), chest X-ray score at day 7 after birth (OR=1.756, 95% CI 1.264 to 2.440, p<0.001) and extended invasive mechanical ventilation to day 7 after birth (OR=4.280, 95% CI 2.149 to 8.526, p<0.001). In training and validation cohorts, the area under the curve was 0.873 (95% CI 0.839 to 0.907) and 0.848 (95% CI 0.778 to 0.917), respectively. In addition, the calibration curves showed good agreement between the column-line graph model and the actual observations. A decision curve analysis indicated a significantly better net benefit of the model. Higher chest X-ray scores within 7 days of life and extended invasive mechanical ventilation to day 7 after birth were significantly associated with BPD. The model had good predictive performance for predicting BPD using birth weight, chest X-ray scores within 24 hours of birth and at day 7 after life, and the state of invasive mechanical ventilation at day 7 after birth.