Abstract：
OBJECTIVE: To describe risk factors of bronchopulmonary dysplasia in very preterm infants in the first weeks of life.
METHODS: Retrospective cohort study of preterm infants ≤ 32 weeks of gestational age and birth weight ≤ 1500 g. A multivariate logistic regression analysis was performed to identify independent risk factors for bronchopulmonary dysplasia in the first weeks of life.
RESULTS: A total of 202 newborns were included in the study (mean gestational age 29.5 ± 2.1 weeks), 61.4% never received invasive mechanical ventilation. The incidence of bronchopulmonary dysplasia was 28.7%, and 10.4% of the patients were diagnosed with moderate-severe bronchopulmonary dysplasia. Bronchopulmonary dysplasia was independently associated with gestational age (P < 0.001; OR = 0.44 (95% CI = 0.30-0.65)), the need for mechanical ventilation on the first day of life (P = 0.001; OR = 8.13 ((95% CI = 2.41-27.42)), nosocomial sepsis (P < 0.001; OR = 9.51 ((95% CI = 2.99-30.28)) and FiO2 on day 14 (P < 0.001; OR = 1.39 ((95% CI = 1.16-1.66)). Receiving mechanical ventilation at the first day of life (P = 0.008; OR = 5.39 ((95% CI = 1.54-18.89)) and at the third day of life (P = 0.001; OR = 9.99 ((95% CI = 2.47-40.44)) and nosocomial sepsis (P = 0.001; OR = 9.87 ((95% CI = 2.58-37.80)) were independent risk factors for moderate-severe bronchopulmonary dysplasia.
CONCLUSIONS: Gestational age, mechanical ventilation in the first days of life and nosocomial sepsis are early risk factors for bronchopulmonary dysplasia. The analysis of simple and objective clinical data, allows us to select a group of patients at high risk of bronchopulmonary dysplasia in whom it could be justified to act more aggressively, and shows areas for improvement to prevent its development or reduce its severity.
METHODS: Retrospective cohort study of preterm infants ≤ 32 weeks of gestational age and birth weight ≤ 1500 g. A multivariate logistic regression analysis was performed to identify independent risk factors for bronchopulmonary dysplasia in the first weeks of life.
RESULTS: A total of 202 newborns were included in the study (mean gestational age 29.5 ± 2.1 weeks), 61.4% never received invasive mechanical ventilation. The incidence of bronchopulmonary dysplasia was 28.7%, and 10.4% of the patients were diagnosed with moderate-severe bronchopulmonary dysplasia. Bronchopulmonary dysplasia was independently associated with gestational age (P < 0.001; OR = 0.44 (95% CI = 0.30-0.65)), the need for mechanical ventilation on the first day of life (P = 0.001; OR = 8.13 ((95% CI = 2.41-27.42)), nosocomial sepsis (P < 0.001; OR = 9.51 ((95% CI = 2.99-30.28)) and FiO2 on day 14 (P < 0.001; OR = 1.39 ((95% CI = 1.16-1.66)). Receiving mechanical ventilation at the first day of life (P = 0.008; OR = 5.39 ((95% CI = 1.54-18.89)) and at the third day of life (P = 0.001; OR = 9.99 ((95% CI = 2.47-40.44)) and nosocomial sepsis (P = 0.001; OR = 9.87 ((95% CI = 2.58-37.80)) were independent risk factors for moderate-severe bronchopulmonary dysplasia.
CONCLUSIONS: Gestational age, mechanical ventilation in the first days of life and nosocomial sepsis are early risk factors for bronchopulmonary dysplasia. The analysis of simple and objective clinical data, allows us to select a group of patients at high risk of bronchopulmonary dysplasia in whom it could be justified to act more aggressively, and shows areas for improvement to prevent its development or reduce its severity.
摘要：
目的：描述极早产儿出生后第一周支气管肺发育不良的危险因素。
方法：对胎龄≤32周、出生体重≤1500g的早产儿进行回顾性队列研究。采用多因素logistic回归分析确定出生后第1周支气管肺发育不良的独立危险因素。
结果：共有202名新生儿被纳入研究（平均胎龄29.5±2.1周），61.4%从未接受过有创机械通气。支气管肺发育不良的发生率为28.7%,10.4%的患者被诊断为中重度支气管肺发育不良。支气管肺发育不良与胎龄独立相关(P<0.001;OR=0.44(95%CI=0.30-0.65)),生命第一天需要机械通气（P=0.001；OR=8.13（（95％CI=2.41-27.42）），医院败血症（P<0.001；OR=9.51（（95％CI=2.99-30.28））和第14天的FiO2（P<0.001；OR=1.39（（95％CI=1.16-1.66））。在生命的第一天（P=0.008；OR=5.39（（95％CI=1.54-18.89））和生命的第三天（P=0.001；OR=9.99（（95％CI=2.47-40.44））接受机械通气和院内败血症（P=0.001；OR=9.87（（95％CI=2.58-37.80））是中重度支气管发育不良的独立危险因素。
结论：妊娠年龄，生命初期机械通气和院内败血症是支气管肺发育不良的早期危险因素。简单客观的临床资料分析,允许我们选择一组支气管肺发育不良高风险的患者，他们有理由采取更积极的行动，并显示需要改进的地方，以防止其发展或减少其严重程度。
方法：对胎龄≤32周、出生体重≤1500g的早产儿进行回顾性队列研究。采用多因素logistic回归分析确定出生后第1周支气管肺发育不良的独立危险因素。
结果：共有202名新生儿被纳入研究（平均胎龄29.5±2.1周），61.4%从未接受过有创机械通气。支气管肺发育不良的发生率为28.7%,10.4%的患者被诊断为中重度支气管肺发育不良。支气管肺发育不良与胎龄独立相关(P<0.001;OR=0.44(95%CI=0.30-0.65)),生命第一天需要机械通气（P=0.001；OR=8.13（（95％CI=2.41-27.42）），医院败血症（P<0.001；OR=9.51（（95％CI=2.99-30.28））和第14天的FiO2（P<0.001；OR=1.39（（95％CI=1.16-1.66））。在生命的第一天（P=0.008；OR=5.39（（95％CI=1.54-18.89））和生命的第三天（P=0.001；OR=9.99（（95％CI=2.47-40.44））接受机械通气和院内败血症（P=0.001；OR=9.87（（95％CI=2.58-37.80））是中重度支气管发育不良的独立危险因素。
结论：妊娠年龄，生命初期机械通气和院内败血症是支气管肺发育不良的早期危险因素。简单客观的临床资料分析,允许我们选择一组支气管肺发育不良高风险的患者，他们有理由采取更积极的行动，并显示需要改进的地方，以防止其发展或减少其严重程度。
