Search

Background: Longer hospitalizations for preterm infants with bronchopulmonary dysplasia (BPD) delay developmental outcomes, increase the risk for hospital-acquired complications, and exert a substantial socioeconomic burden. This study aimed to identify factors associated with an extended length of stay (LOS) at different levels of severity of BPD., Methods: A cohort study was conducted using the Korean Neonatal Network registry of very low birth weight infants with BPD between 2013 and 2017 through retrospective analysis., Results: A total of 4263 infants were diagnosed with BPD. For mild BPD, infants requiring surgical treatment for patent ductus arteriosus needed a longer LOS [e adjusted β coefficients (adj β) 1.041; 95% confidence interval (CI): 0.01-0.08] and hydrocephalus (e adj β 1.094; 95% CI 0.01-0.17). In moderate BPD, infants administered steroids or with intraventricular hemorrhage required a longer LOS (e adj β 1.041; 95% CI 0.00-0.07 and e adj β 1.271; 95% CI 0.11-0.38, respectively). In severe BPD, infants with comorbidities required a longer LOS: pulmonary hypertension (e adj β 1.174; 95% CI 0.09-0.23), administrated steroid for BPD (e adj β 1.116; 95% CI 0.07-0.14), sepsis (e adj β 1.062; 95% CI 0.01-0.11), patent ductus arteriosus requiring surgical ligation (e adj β 1.041; 95% CI 0.00-0.08), and intraventricular hemorrhage (e adj β 1.016; 95% CI 0.05-0.26). Additionally, the higher the clinical risk index score, the longer the LOS needed for infants in all groups., Conclusions: The factors affecting LOS differed according to the severity of BPD. Individualized approaches to reducing LOS may be devised using knowledge of the various risk factors affecting LOS by BPD severity., (© 2024. The Author(s).)

We retrospectively analyzed National Health Insurance claims data (January 2002-December 2018) to determine the asthma prevalence and risk factors among preterm infants born in Korea. Patients with asthma were defined as those with a history of asthma medication prescriptions at least twice per year with International Classification of Diseases, Tenth Edition codes J45 and J46. We enrolled 99,139 preterm infants. The prevalence of asthma among preterm and term infants was 32.7% and 26.9%, 21.2% and 19.1%, 6.7% and 5.9%, 2.0%, and 1.6%, and 2.4% and 1.6% at 2, 5, 10, 15, and 16 years of age, respectively. The relative risk (RR) of asthma in preterm infants was 1.1-fold that in female preterm infants. The RR of asthma medication prescriptions for infants with extreme prematurity was 1.92-fold that of infants with moderate/late pre-term status. Among preterm with bronchopulmonary dysplasia (BPD) and respiratory distress syndrome (RDS) without comorbidities, the RRs for the number of asthma medication prescriptions were 1.34 and 1.06, respectively. This study revealed a higher prevalence of asthma among preterm infants than that in term infants. Male sex, extreme prematurity, BPD, and RDS were identified as risk factors for asthma medication prescriptions in preterm infants., (© 2023. The Author(s).)

Little is known about the association between body proportionality at birth and neonatal outcomes in preterm infants. Body mass index (BMI) is one of the weigh-for-length ratios that represent body proportionality. The objective of this study was to examine whether BMI at birth affects neonatal outcomes in preterm infants. We assessed 3115 preterm (< 30 weeks), very low birth weight (< 1500 g) infants born between January 2013 and December 2016 and registered in the Korean Neonatal Network database. Using gender-specific BMI for gestational age curves, z-scores of BMI at birth were calculated. Low-, normal-, and high-BMI were defined as BMI z-scores of less than − 1, from − 1 to 1, and greater than 1, respectively. Neonatal morbidities and mortality in low- and high-BMI groups were compared to those in normal-BMI group. The low-BMI group had an increased risk of bronchopulmonary dysplasia, bronchopulmonary dysplasia or death, and necrotizing enterocolitis after adjusting for baseline characteristics and the birth weight z-score. High-BMI group had comparable neonatal outcomes to those of normal-BMI group. Low BMI at birth was associated with an increased risk of bronchopulmonary dysplasia and necrotizing enterocolitis, whereas High BMI at birth was not associated with adverse neonatal outcomes. [ABSTRACT FROM AUTHOR]