Respiratory Outcomes at 12 Months of Corrected Age of Preterm Infants with Severe Bronchopulmonary Dysplasia Requiring Protracted Invasive Ventilation

Abstract

Objective: The objective of this study was to describe respiratory and neurodevelopmental outcomes in infants with severe bronchopulmonary dysplasia (BPD) who needed invasive ventilation until 36 weeks’ postmenstrual age (PMA). Methods: A retrospective observational single-center study was conducted in our hospital. Eighty preterm infants born between January 2007 and December 2016 with less than 28 weeks’ gestational age and classified as having severe BPD were included in the study. Patients with invasive ventilation at 36 weeks’ PMA (invasive group) were compared with those with noninvasive ventilation (noninvasive group) in terms of perinatal characteristics and postnatal outcomes. Results: Antenatal characteristics and basic patient characteristics were comparable between the two groups. Incidence of pulmonary hemorrhage (13.6 vs. 1.7%, P=0.061) and clinical sepsis (66.7 vs. 31.0%, P=0.004) was more in the invasive group. Invasive group had longer hospital stay (133.50± 104.52 vs. 114.00±24.71 days, P=0.031), higher rates of readmission due to respiratory problems before 12 months of corrected age (57.1 vs. 32.1%, P=0.045), higher rates of having a tracheostomy (22.7 vs. 1.7%, P=0.005), and higher rates of infants with respiratory support at a corrected age of 6 months (22.7 vs. 3.5%, P=0.016). Neurodevelopmental outcomes including Bayley Scales of Infant Development-III, cerebral palsy, hearing aid, blindness, and composite outcome of them revealed no differences between the two groups. Conclusion: Invasive ventilation until postmenstrual age of 36 weeks does not predict poorer neurodevelopmental outcomes in infants with severe BPD. However, the invasive group was more prone to develop respiratory problems after discharge.