Objective To analyze the risk factors of bronchopulmonary dysplasia (BPD) in very low birth weight infants with neonatal respiratory distress syndrome (NRDS) and gestational age < 32 weeks,in order to provide reference for the prevention of BPD. Methods A total of 138 cases of preterm infants diagnosed with NRDS,with gestational age < 32 weeks and birth weight < 1 500 g,were enrolled into this study from October 2019 to July 2020 in the Neonatal Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University,and were divided into BPD group (n=32) and non-BPD group (n=106). Data on birth,treatment and pregnancy were collected and analyzed to determine the risk factors of BPD in these infants. Results Single factors analysis showed that there were significant differences in gestational age,birth weight,mechanical ventilation,glucocorticoids usage after birth,incidence rates of neonatal infection and prenatal infection between BPD group and non-BPD group (t=3.444,2.912,χ2=24.089,5.208,8.586,9.486,P＜0.05). Multivariate Logistic regression showed that gestational age ≥28 weeks was a protective factor for BPD(28—＜30 weeks OR=0.143,95%CI:0.035—0.579;30—＜32 weeks:OR=0.210,95%CI:0.047—0.939),while mechanical ventilation (OR=5.459,95%CI:1.991—14.963),neonatal infection (OR=4.075,95%CI:1.031—16.106) and prenatal infection(OR=3.375,95%CI:1.051—10.833)were independent risk factors of BPD (P<0.05). Conclusion Preventing infection,avoiding preterm delivery and reducing mechanical ventilation are important measures to reduce BPD in preterm infants diagnosed with NRDS,with gestational age < 32 weeks and birth weight < 1 500 g.
Key words
neonatal respiratory distress syndrome /
bronchopulmonary dysplasia /
preterm infants
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References
[1] 王丹丹,孙健伟,高峰,等.早产儿支气管肺发育不良的病因及治疗进展[J].现代临床医学,2020,46(1):69-72.
[2] 邵肖梅,叶鸿瑁,丘小汕,等.实用新生儿学[M].4版.北京:人民卫生出版社,2011:395-398.
[3] Jobe AH,Bancalari E. Bronchopulmonary dysplasia[J].Am J Respir Crit Care Med,2001,163(7):1723-1729.
[4] 沙得哈西·卡马力汗,丁效国,杨丽,等.支气管肺发育不良早产儿的临床特征及危险因素分析[J].中国现代医学杂志,2019,29(23):98-102.
[5] Klinger G,Sokolover N,Boyko V,et al. Perinatal risk factors for bronchopulmonary dysplasia in a national cohort of very-low-birthweight infants[J].Am J Obstet Gyncol,2013,208(2):111-115.
[6] 韩芳,衣京梅,石秀玉,等.小于32周早产儿支气管肺发育不良的危险因素分析[J].解放军医学院学报,2019,40(4):321-324,327.
[7] Balany J,Bhandari V. Understanding the impact of infection,inflammation,and their persistence in the pathogenesis of bronchopulmonary dysplasia[J].Front Med,2015,2:90.
[8] Prometnoy DV,Alexandrovich YS,Voronenko II. Risk factors,predictors and contemporary diagnostics of bronchopulmonary dysplasia[J].Pediatrician (St. Petersburg),2017,8(3):142-150.
[9] Roseanne JSV,Wes O,Aleid GW,et al. Restricted ventilation associated with reduced neurodevelopmental impairment in preterm infants[J].Neonatology,2017,112(2):172-179.
[10] 章礼真.支气管肺发育不良发病机制及防治策略研究进展[J].安徽医学,2017,38(3):385-388.
[11] Rostas SE,Mcpherson C. Systemic corticosteroids for the prevention of bronchopulmonary dysplasia:picking the right drug for the right baby[J].Neonatal network:NN,2016,35(4):234-239.
[12] 谭开卷,曾秋月,陈凤喜.呼吸窘迫综合征早产儿发生支气管肺发育不良的危险因素[J].医学理论与实践,2020,33(4):617-618.
[13] Renjithkumar KT,Milenka CG,Binoy S. Bronchopulmonary dysplasia:a review of pathogenesis and pathophysiology[J].Respir Med,2017,132:170-177.
[14] Eriksson L,Haglund B,Odlind V,et al. Perinatal conditions related to growth restriction and inflammation are associated with an increased risk of bronchopulmonary dysplasia[J].Acta Paediatrica,2015,104(3):259-263.
[15] 杨耀锋,丁红辉. 早产儿解脲脲原体感染与支气管肺发育不良的相关性分析[J].中国医药导报,2015,12(3):49-52.
[16] 早产儿支气管肺发育不良调查协作组.早产儿支气管肺发育不良发生率及高危因素的多中心回顾调查分析[J].中华儿科杂志,2011,49(9):655-662.
[17] 彭磊,乐功芳,陈绪萍,等.早产儿支气管肺发育不良的高危因素及防治对策[J].临床肺科杂志,2015,20(1):92-95.
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