极早产儿中/重度支气管肺发育不良发生风险的 预测模型构建.

Objective To identify risk factors for moderate to severe bronchopulmonary dysplasia (BPD) in extremely preterm infants born at less than 32 weeks' gestational age and to develop an early predictive nomogram model. Methods A retrospective analysis was conducted on extremely preterm infants born between January 2019 and December 2020 at the Third Affiliated Hospital of Guangzhou Medical University who developed BPD. Perinatal data and clinical information during hospitalization were collected, and risk factors for moderate to severe BPD were identified using logistic regression analysis. Based on these findings, a nomogram prediction model was constructed and internally validated using the Bootstrap method. An external validation cohort was selected from infants born between January 2021 and June 2021 meeting the same inclusion and exclusion criteria. Both the training and validation groups were used to assess the model's discrimination and accuracy. Results A total of 266 extremely preterm infants with BPD were included in the model development cohort, comprising 189 cases of mild BPD (71.1%) and 77 cases of moderate to severe BPD (28.9%). Multivariate logistic regression analysis indicated that preeclampsia, pneumonia, duration of invasive ventilation, and hemodynamically significant patent ductus arteriosus (hsPDA) were significant risk factors for moderate to severe BPD (P<0.05). The nomogram model constructed using these four factors demonstrated an area under the curve (AUC) of 0.810 (95% CI: 0.750-0.870) in the model development cohort and 0. 900 (95% CI: 0.826-0.975) in the validation cohort, with calibration curves close to the ideal diagonal line, indicating good calibration. Conclusion Preeclampsia, pneumonia, duration of invasive ventilation, and hsPDA are independent risk factors for moderate to severe BPD in extremely preterm infants. The nomogram model combining these four indicators demonstrates good predictive value, aiding in early identification of infants at risk of moderate to severe BPD to improve prevention and management outcomes. [ABSTRACT FROM AUTHOR]