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Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center

Unlike other complications among very low birth weight infants (VLBW), the incidence of bronchopulmonary dysplasia (BPD) has not decreased substantially, partly because of the different definitions of BPD applied by different researchers. In this retrospective cohort study, we aimed to compare the 2...

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Autores principales: Sun, Ling, Zhang, Hong, Bao, Yingying, Li, Wenying, Wu, Jingyuan, He, Yuanyuan, Zhu, Jiajun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042161/
https://www.ncbi.nlm.nih.gov/pubmed/33859971
http://dx.doi.org/10.3389/fped.2021.648972
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author Sun, Ling
Zhang, Hong
Bao, Yingying
Li, Wenying
Wu, Jingyuan
He, Yuanyuan
Zhu, Jiajun
author_facet Sun, Ling
Zhang, Hong
Bao, Yingying
Li, Wenying
Wu, Jingyuan
He, Yuanyuan
Zhu, Jiajun
author_sort Sun, Ling
collection PubMed
description Unlike other complications among very low birth weight infants (VLBW), the incidence of bronchopulmonary dysplasia (BPD) has not decreased substantially, partly because of the different definitions of BPD applied by different researchers. In this retrospective cohort study, we aimed to compare the 2018 revised definition and the 2001 consensus definition of BPD proposed by the National Institute of Child Health and Human Development (NICHD), as well as to identify which definition better predicts severe respiratory morbidities or death. We included 417 infants born at a gestational age <32 weeks and classified them as having BPD or without BPD based on the two definitions, with a final follow-up at 18–24 months. We performed between-group comparisons of death and respiratory outcomes. Statistical analyses were performed using descriptive statistics, comparative tests, and receiver operating characteristic curves. The mean ± standard deviation gestational age and birth weight of the 417 eligible infants were 29.1 ± 1.4 weeks and 1186.6 ± 197.8 g, respectively. Among the included infants, five and three infants died before and after 36 weeks of post-menstrual age (PMA), respectively, with 68 and 344 infants evaluated at discharge and 36 weeks' PMA, respectively. We diagnosed 163 (39.1%) and 70 (16.8%) infants with BPD according to the 2001 and 2018 NICHD definitions, respectively. The 2001 NICHD definition displayed a higher sensitivity (0.60 vs. 0.28), better negative predictive value (0.89 vs. 0.85), and larger area under the receiver operating characteristic curve (0.66 vs. 0.57), but a lower specificity (0.65 vs. 0.87) and worse positive predictive value (0.26 vs. 0.31), than the 2018 definition for serious respiratory morbidity or mortality at a corrected age of 18–24 months. Compared with the 2018 NICHD definition of BPD, the 2001 NICHD consensus definition may result in more cases of false-positive or unclassified severity. However, it may be a better indicator of severe respiratory morbidities or death during the first 18–24 months. Nevertheless, there is a need for future studies to assess the validity of the new diagnostic criteria.
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spelling pubmed-80421612021-04-14 Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center Sun, Ling Zhang, Hong Bao, Yingying Li, Wenying Wu, Jingyuan He, Yuanyuan Zhu, Jiajun Front Pediatr Pediatrics Unlike other complications among very low birth weight infants (VLBW), the incidence of bronchopulmonary dysplasia (BPD) has not decreased substantially, partly because of the different definitions of BPD applied by different researchers. In this retrospective cohort study, we aimed to compare the 2018 revised definition and the 2001 consensus definition of BPD proposed by the National Institute of Child Health and Human Development (NICHD), as well as to identify which definition better predicts severe respiratory morbidities or death. We included 417 infants born at a gestational age <32 weeks and classified them as having BPD or without BPD based on the two definitions, with a final follow-up at 18–24 months. We performed between-group comparisons of death and respiratory outcomes. Statistical analyses were performed using descriptive statistics, comparative tests, and receiver operating characteristic curves. The mean ± standard deviation gestational age and birth weight of the 417 eligible infants were 29.1 ± 1.4 weeks and 1186.6 ± 197.8 g, respectively. Among the included infants, five and three infants died before and after 36 weeks of post-menstrual age (PMA), respectively, with 68 and 344 infants evaluated at discharge and 36 weeks' PMA, respectively. We diagnosed 163 (39.1%) and 70 (16.8%) infants with BPD according to the 2001 and 2018 NICHD definitions, respectively. The 2001 NICHD definition displayed a higher sensitivity (0.60 vs. 0.28), better negative predictive value (0.89 vs. 0.85), and larger area under the receiver operating characteristic curve (0.66 vs. 0.57), but a lower specificity (0.65 vs. 0.87) and worse positive predictive value (0.26 vs. 0.31), than the 2018 definition for serious respiratory morbidity or mortality at a corrected age of 18–24 months. Compared with the 2018 NICHD definition of BPD, the 2001 NICHD consensus definition may result in more cases of false-positive or unclassified severity. However, it may be a better indicator of severe respiratory morbidities or death during the first 18–24 months. Nevertheless, there is a need for future studies to assess the validity of the new diagnostic criteria. Frontiers Media S.A. 2021-03-30 /pmc/articles/PMC8042161/ /pubmed/33859971 http://dx.doi.org/10.3389/fped.2021.648972 Text en Copyright © 2021 Sun, Zhang, Bao, Li, Wu, He and Zhu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Sun, Ling
Zhang, Hong
Bao, Yingying
Li, Wenying
Wu, Jingyuan
He, Yuanyuan
Zhu, Jiajun
Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
title Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
title_full Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
title_fullStr Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
title_full_unstemmed Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
title_short Long-Term Outcomes of Bronchopulmonary Dysplasia Under Two Different Diagnostic Criteria: A Retrospective Cohort Study at a Chinese Tertiary Center
title_sort long-term outcomes of bronchopulmonary dysplasia under two different diagnostic criteria: a retrospective cohort study at a chinese tertiary center
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042161/
https://www.ncbi.nlm.nih.gov/pubmed/33859971
http://dx.doi.org/10.3389/fped.2021.648972
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