Cargando…

The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery

BACKGROUND: Despite the advances in neonatology, the incidence of bronchopulmonary dysplasia (BPD) is increasing. It is important to prevent the development of BPD in the first place. The online BPD outcome estimator from National Institute of Children Health and Human Development and Neonatal Resea...

Descripción completa

Detalles Bibliográficos
Autores principales: Shim, So-Yeon, Yun, Ji Yun, Cho, Su Jin, Kim, Min Ho, Park, Eun Ae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985290/
https://www.ncbi.nlm.nih.gov/pubmed/33754511
http://dx.doi.org/10.3346/jkms.2021.36.e81
_version_ 1783668214075490304
author Shim, So-Yeon
Yun, Ji Yun
Cho, Su Jin
Kim, Min Ho
Park, Eun Ae
author_facet Shim, So-Yeon
Yun, Ji Yun
Cho, Su Jin
Kim, Min Ho
Park, Eun Ae
author_sort Shim, So-Yeon
collection PubMed
description BACKGROUND: Despite the advances in neonatology, the incidence of bronchopulmonary dysplasia (BPD) is increasing. It is important to prevent the development of BPD in the first place. The online BPD outcome estimator from National Institute of Children Health and Human Development and Neonatal Research Network is available. However, it is not applicable for Asians. Moreover, limits are set for birth weight and gestational weeks excluding those who may still have BPD. The aim of this study was to develop a prediction model for BPD using first hour perinatal and neonatal factors in Korean very low birth weight infants (VLBWIs). METHODS: Data were collected for 8,022 VLBWIs with gestational age (GA) ≥ 22 weeks who were born between January 1, 2013 and December 31, 2016, and admitted to the neonatal intensive care units of the KNN. Multiple logistic regression models reanalyzed by stepwise selection with significant clinical indicators for BPD. PROC package was used to calculate the area under curve (AUC) and corresponding 95% confidence intervals. Moreover, it was used to search the best cut-off value. External validation was performed with the 2017 Korean neonatal network (KNN) data. RESULTS: After all missing data were excluded, 4,600 VLBWIs were included in the training dataset of the prediction model. Predictability of presence of BPD was 90.8% and prediction P value cut off was 0.550. Five-minute Apgar score, birth weight, GA, sex, surfactant use were significant indicators. Predictability of severe BPD was 81.5% and prediction P value cut off was 0.160. Five-minute Apgar score, birth weight, maternal PIH, chronic maternal hypertension, GA, sex, respiratory distress syndrome, need of resuscitation at birth were significant indicators. After external validation, sensitivity and specificity did not change significantly. CONCLUSION: From this study, high predictability was obtained using clinical parameters obtained within one hour of life. P value for prediction of each grade of BPD and equation for calculation was presented. It can be helpful for the early prediction of BPD in Korean VLBWI. This study will contribute to the prediction of BPD in Asians especially Korean VLBWIs, not currently included in the NICHD BPD online BPD predictor. In addition, the predictive power may be continuously increased with the cumulative data of KNN.
format Online
Article
Text
id pubmed-7985290
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher The Korean Academy of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-79852902021-03-31 The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery Shim, So-Yeon Yun, Ji Yun Cho, Su Jin Kim, Min Ho Park, Eun Ae J Korean Med Sci Original Article BACKGROUND: Despite the advances in neonatology, the incidence of bronchopulmonary dysplasia (BPD) is increasing. It is important to prevent the development of BPD in the first place. The online BPD outcome estimator from National Institute of Children Health and Human Development and Neonatal Research Network is available. However, it is not applicable for Asians. Moreover, limits are set for birth weight and gestational weeks excluding those who may still have BPD. The aim of this study was to develop a prediction model for BPD using first hour perinatal and neonatal factors in Korean very low birth weight infants (VLBWIs). METHODS: Data were collected for 8,022 VLBWIs with gestational age (GA) ≥ 22 weeks who were born between January 1, 2013 and December 31, 2016, and admitted to the neonatal intensive care units of the KNN. Multiple logistic regression models reanalyzed by stepwise selection with significant clinical indicators for BPD. PROC package was used to calculate the area under curve (AUC) and corresponding 95% confidence intervals. Moreover, it was used to search the best cut-off value. External validation was performed with the 2017 Korean neonatal network (KNN) data. RESULTS: After all missing data were excluded, 4,600 VLBWIs were included in the training dataset of the prediction model. Predictability of presence of BPD was 90.8% and prediction P value cut off was 0.550. Five-minute Apgar score, birth weight, GA, sex, surfactant use were significant indicators. Predictability of severe BPD was 81.5% and prediction P value cut off was 0.160. Five-minute Apgar score, birth weight, maternal PIH, chronic maternal hypertension, GA, sex, respiratory distress syndrome, need of resuscitation at birth were significant indicators. After external validation, sensitivity and specificity did not change significantly. CONCLUSION: From this study, high predictability was obtained using clinical parameters obtained within one hour of life. P value for prediction of each grade of BPD and equation for calculation was presented. It can be helpful for the early prediction of BPD in Korean VLBWI. This study will contribute to the prediction of BPD in Asians especially Korean VLBWIs, not currently included in the NICHD BPD online BPD predictor. In addition, the predictive power may be continuously increased with the cumulative data of KNN. The Korean Academy of Medical Sciences 2021-03-12 /pmc/articles/PMC7985290/ /pubmed/33754511 http://dx.doi.org/10.3346/jkms.2021.36.e81 Text en © 2021 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shim, So-Yeon
Yun, Ji Yun
Cho, Su Jin
Kim, Min Ho
Park, Eun Ae
The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery
title The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery
title_full The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery
title_fullStr The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery
title_full_unstemmed The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery
title_short The Prediction of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants through Clinical Indicators within 1 Hour of Delivery
title_sort prediction of bronchopulmonary dysplasia in very low birth weight infants through clinical indicators within 1 hour of delivery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985290/
https://www.ncbi.nlm.nih.gov/pubmed/33754511
http://dx.doi.org/10.3346/jkms.2021.36.e81
work_keys_str_mv AT shimsoyeon thepredictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT yunjiyun thepredictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT chosujin thepredictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT kimminho thepredictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT parkeunae thepredictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT shimsoyeon predictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT yunjiyun predictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT chosujin predictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT kimminho predictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery
AT parkeunae predictionofbronchopulmonarydysplasiainverylowbirthweightinfantsthroughclinicalindicatorswithin1hourofdelivery