Three-year evaluation of patients with bronchopulmonary dysplasia

Introduction and Purpose: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that develops in premature infants who require prolonged oxygen therapy and positive pressure ventilation due to severe respiratory failure. Despite advances in neonatal care, BPD remains one of the most common long-term complications in preterm infants. This study aimed to identify the main risk factors contributing to the development of BPD by examining various prenatal, perinatal, and postnatal characteristics of infants diagnosed with BPD and treated in the Neonatal Intensive Care Unit of Dicle University Faculty of Medicine. Materials and Methods: This study is a clinical and retrospective cross-sectional analysis. It includes data from a total of 128 patients diagnosed with BPD who were hospitalized between January 1, 2020, and December 31, 2022, in the Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Dicle University. Patients were categorized into two groups based on the severity of BPD: mild/moderate and severe. The clinical data of these groups were then compared. Results: Of the patients included in the study, 56.3% were male (n=72) and 43.8% were female (n=56). In the severe BPD group, both birth weight (809.4 ± 254.1 g) and gestational age (25.7 ± 2.1 weeks) were significantly lower compared to the mild/moderate BPD group (p=0.001). Severe BPD was more frequently observed in infants with a birth weight of 500–749 g (40.5%; p=0.022) and those born at 22–24 weeks of gestation (29.7%; p<0.001). The rate of in vitro fertilization (IVF) was significantly higher in the mild/moderate BPD group (39.6% vs. 18.9%; p=0.025), as was the incidence of chorioamnionitis (p=0.025). In terms of respiratory support, mechanical ventilation and nasal CPAP durations were significantly longer in the severe BPD group (p<0.05). Total parenteral nutrition (TPN) duration was also longer in this group (18.1 ± 13.3 days vs. 10.6 ± 7.2 days; p<0.001). The need for red blood cell transfusions, the incidence of necrotizing enterocolitis (NEC), and culture-positive sepsis were higher in the severe BPD group, whereas clinical sepsis was more frequent in the mild/moderate group (p<0.05). Furthermore, the use of additional steroids, duration of caffeine therapy, and the need for retinopathy of prematurity (ROP) treatment were all significantly greater in the severe BPD group (p<0.05). Length of hospital stay (112.3 ± 47.2 days vs. 84.5 ± 31.3 days) and mortality rate (16.2% vs. 2.2%) were also significantly higher in this group (p<0.05). Conclusion: This study demonstrated that premature infants who developed severe BPD had significantly lower birth weights and gestational ages, prolonged requirements for respiratory and parenteral nutritional support, and higher rates of infection and complications. Early diagnosis, close monitoring of high-risk groups, and individualized supportive therapies may play a crucial role in reducing the incidence of severe BPD and its associated morbidity and mortality.