Development and verification of a risk prediction model for bronchopulmonary dysplasia in very low birth weight infants

Abstract

Background: To analyze the risk factors of bronchopulmonary dysplasia (BPD) of very low birth weight infants (VLBWIs), and to develop and verify a risk prediction model of BPD. Methods: The data of 611 VLBWIs from the neonatal intensive care unit (NICU) of a tertiary grade A hospital in Suzhou from January 2017 to September 2019 were collected. The data was randomly divided into the modeling set (451 cases) and the validation set (160 cases). Binary logistic regression was used to analyze the data, and the model was examined by a receiver operating characteristic (ROC) curve. The grouped data was used to verify the sensitivity and specificity of the model. Results: The study found that neonatal asphyxia, the positive rate of sputum culture, neonatal sepsis, neonatal respiratory distress syndrome (NRDS), blood transfusions (≥3), patent ductus arteriosus (PDA), the time of invasive mechanical ventilation, the duration of oxygen therapy, and the time of parenteral nutrition were the independent risk factors of BPD, while 1 min Apgar score was a protective factor. The model formula was Z=neonatal asphyxia * 1.229 + the positive rate of sputum culture * 1.265 + neonatal sepsis * 1.677 + NRDS * 1.848 + blood transfusions (≥3) * 1.455 + PDA * 1.835 − 1 min Apgar score * 0.25 + the time of invasive mechanical ventilation * 0.123 + the duration of oxygen therapy * 0.09 + the time of parenteral nutrition * 0.057 − 8.077. The area under the ROC curve of this model was 0.965 (95% CI: 0.946-0.983),with a sensitivity of 93.7% and a specificity of 91.3%. Verification of this prediction model showed a sensitivity of 92.9% and a specificity of 76%, demonstrating that the effects of this model were satisfactory. Conclusions:The risk prediction model had a good predictive effect for the risk of BPD in VLBWIs, and can provide a reference for preventive treatment and nursing intervention.

Establishment and efficiency analysis of the risk prediction model predicting the likelihood of bronchopulmonary dysplasia in preterm infants: A retrospective observational study

“…The present study found that infants with history of neonatal asphyxia are at high risk of developing BPD, and this nding is consistent with the results of previous studies [21,22]. For infants with small GA and low birth weight, the immature lung development and di culty in postoperative respiratory establishment can easily lead to asphyxia and resuscitation.…”

“…The occurrence of NRDS results in increased pulmonary surfactant consumption, leading to high ventilation pressures, oxygen concentrations, and lung injury to some extent. In the current study, the presence of NRDS is shown to be associated with increased risk of BPD [21], indicating that surfactant therapy should be given as early as possible to promote lung maturation.…”

Association between red blood cell transfusion and bronchopulmonary dysplasia: a systematic review and meta-analysis

“…A total of 1,011 articles were retrieved from the databases using systematic and manual searches. After removing the duplicates, and performing screening of abstracts and full-text articles, 21 studies (5,15,16,19,20,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) were included. These studies included a total of 6,567 control infants and 1,476 patients with BPD, and were eligible for the meta-analysis.…”

Combined gestational age and serum fucose for early prediction of risk for bronchopulmonary dysplasia in premature infants

“…Given the hypoplastic state of the smooth muscle and the lack of intimal cushion, an immature ductus arteriosus might not close timely after birth, causing enhanced blood flow to the lungs, pulmonary edema, lung congestion, and subsequent exacerbation of pulmonary inflammation, declining lung function, and reduced gas exchange. Although the precise role of PDA in BPD onset and progression remains elusive, the risk of BPD in premature infants with PDA was found to be 6.266 times that of non-PDA counterparts, with the BPD risk escalating alongside PDA shunt volume and duration [ 22 , 23 ].…”