Predictors of Bronchopulmonary Dysplasia in Saudi Preterm Infants

Abstract

Background: Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and mortality among preterm infants. Objective: To determine BPD prevalence and to identify factors that predict the development of BPD. Patients and Methods: We performed a retrospective cohort study of all neonates admitted to the neonatal intensive care unit (NICU) between 2009 and 2019 with gestational age (GA) less than 32 weeks and birth weight (BW) less than 1500 g. Results: A total of 637 preterm infants included in the study, of whom 194 (30.5%) infants developed BPD. Of the 194 preterm infants who developed BPD 89 (45.9 %) had mild, 59 (30.4%) had moderate and 46 (23.7%) had severe BPD. Multivariate analysis revealed that low GA (odds ratio [OR]: 0.62; 95% confidence interval [CI]: 0.43-0.98), low BW (OR: 20.6; 95% CI: 17.1-29.3), use of mechanical ventilation (OR: 1.07; 95% CI: 0.87-1.54), higher peak inspiratory pressure (PIP) (OR: 1.48; 95% CI: 1.44-1.91), higher fraction of inspired oxygen (FiO2) use (OR: 0.11; 95% CI: 0.05-0.19), duration of mechanical ventilation (OR: 3.56; 95% CI: 4.28-3.75) and frequent blood transfusion (OR: 0.65; 95% CI: 0.53-0.87) were identified as the principal risk factors for BPD. Conclusions: The prevalence of BPD among Saudi preterm infants was 30.5%. The most relevant predictors of BPD were GA, BW, mechanical ventilation, higher PIP, higher FiO2 use, duration of mechanical ventilation and frequent blood transfusion.