Severe BPD is decreasing

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The major associations with the development of BPD in preterm infants are low gestational age at delivery, chorioamnionitis prior to delivery, mechanical ventilation, supplemental oxygen, postnatal sepsis, and patent ductus artinosis. Clearly BPD is a multifactoral disease. BPD is a significant medical problem because it results in longer hospital stays, increased risks of lung diseases after discharge (severe RSV pneumonia, increased airway reactivity), and severe BPD is associated independently with poor neurodevelopmental outcomes. Despite the widespread use of antenatal corticosteroids and postnatal surfactant, the incidence of BPD has not changed.Smith et al confirm in this issue of The Journal that there has been no change in the incidence in the gestation-adjusted risk of BPD in a large database over a 9-year period. Nevertheless, severe BPD, defined as the need for oxygen plus respiratory support (mechanical ventilation or CPAP), decreased from 9.7% in 1994 to 3.7% in 2002. This represents real progress as the infants with severe BPD are at highest risk for adverse outcomes. A cautionary note is the validity of the diagnosis of BPD based on an oxygen requirement at 36 weeks corrected age only. Walsh MC et al (Pediatr 2004:114;1305-11) demonstrated that oxygen use varies widely between neonatal units and recommends testing if an infant needs supplemental oxygen at 36 weeks corrected age. The major associations with the development of BPD in preterm infants are low gestational age at delivery, chorioamnionitis prior to delivery, mechanical ventilation, supplemental oxygen, postnatal sepsis, and patent ductus artinosis. Clearly BPD is a multifactoral disease. BPD is a significant medical problem because it results in longer hospital stays, increased risks of lung diseases after discharge (severe RSV pneumonia, increased airway reactivity), and severe BPD is associated independently with poor neurodevelopmental outcomes. Despite the widespread use of antenatal corticosteroids and postnatal surfactant, the incidence of BPD has not changed. Smith et al confirm in this issue of The Journal that there has been no change in the incidence in the gestation-adjusted risk of BPD in a large database over a 9-year period. Nevertheless, severe BPD, defined as the need for oxygen plus respiratory support (mechanical ventilation or CPAP), decreased from 9.7% in 1994 to 3.7% in 2002. This represents real progress as the infants with severe BPD are at highest risk for adverse outcomes. A cautionary note is the validity of the diagnosis of BPD based on an oxygen requirement at 36 weeks corrected age only. Walsh MC et al (Pediatr 2004:114;1305-11) demonstrated that oxygen use varies widely between neonatal units and recommends testing if an infant needs supplemental oxygen at 36 weeks corrected age. Trends in severe bronchopulmonary dysplasia rates between 1994 and 2002The Journal of PediatricsVol. 146Issue 4PreviewTo examine temporal trends in the rates of severe bronchopulmonary dysplasia (BPD) between 1994 and 2002. Full-Text PDF