Variability of Very Low Birth Weight Infant Outcome and Practice in Swiss and US Neonatal Units

Adams, Mark; Bassler, Dirk; Bucher, Hans Ulrich; Roth‐Kleiner, Matthias; Berger, Thomas M.; Braun, Julia; Puhan, Milo A.; Edwards, Erika M.; Soll, Roger F.; Wyl, Viktor von

doi:10.1542/peds.2017-3436

Cited by 43 publications

(32 citation statements)

References 35 publications

(28 reference statements)

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“…to 50%, likely because of differences in gestational age or birth weight criteria for confirmed a BPD diagnosis [5][6][7][8][9][10]. A multicenter retrospective analysis from China showed that the incidence of BPD decreases with increase in gestational age and weight [11], which is consistent with the results of previous studies.…”

Section: Discussionsupporting

confidence: 81%

Risk factors of bronchopulmonary dysplasia in premature infants under 32 weeks of gestation: A retrospective case-control study

Cui

2020

Preprint

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Background: Bronchopulmonary dysplasia (BPD) in preterm infants is one of the most serious complications in neonatology, as it significantly affects the quality of life of preterm children. We retrospectively analyze the incidence and risk factors of BPD in premature infants under 32 weeks of gestation age.Methods: Clinical data of premature infants with gestational age ≤32 weeks admitted to the neonatal intensive care unit of the First Affiliated Hospital of Nanjing Medical University from 2015 to 2017 were selected for this retrospective case-control study. The patients were classified into the BPD and control groups based on the clinical diagnosis. We compared the general condition, treatments, complications, and clinical outcome of premature infants in both groups. Student’s t-test, non-parametric test, and binary logistic regression were used to analyze the occurrence of BPD and its potential risk factors.Results: A total of 213 premature infants aged ≤32 gestational weeks were included in the study; of these, 81 (38%) were diagnosed with BPD. The gestational age (29.14±1.88 weeks vs. 30.82±0.98 weeks, P<0.001) and weight (1240±314.87 g vs. 1584.77±318.18 g, P<0.001) in the BPD group were lower than those in the control group. The liquid quantity, urine volume, and calorie intake of preterm infants in the BPD group within one week after birth were significantly lower than those of infants in the control group. Logistic regression analysis showed that invasive mechanical ventilation (OR=5.065, 95% CI: 1.680–15.266); use of erythrocyte suspension (OR=10.146, 95% CI: 1.860–55.336); and PCO2 in early postnatal arterial blood gas (OR=1.122, 95% CI: 1.024–1.229) were risk factors for BPD. On the other hand, gestational age (OR=0.657, 95% CI: 0.460–0.937); calorie intake (OR=0.917, 95% CI: 0.874–0.963); PO2 (OR=0.925, 95% CI: 0.870–0.985); and pH in early postnatal arterial blood gas (OR<0.001, 95% CI: 0.000–0.156) were protective factors for BPD.Conclusion: The incidence of BPD in very low and extremely low birth weight infants is high. Maintaining early internal environment stability, increasing early calorie intake, shortening invasive mechanical ventilation time, reducing blood transfusion, and closing patent ductus arteriosus could likely reduce the incidence of BPD.

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Section: Discussionsupporting

confidence: 81%

Risk factors of bronchopulmonary dysplasia in premature infants under 32 weeks of gestation: A retrospective case-control study

Cui

2020

Preprint

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“…These results make our study different from previous studies, as our study focused on the treatment of established BPD in premature infants. Ahn's study suggested that the injection of allogeneic MSCs could reduce the risk of BPD (11,23,24). It was suggested that the earliest time at whichBPD can be predicted is day 4 of life, when the peak inspiratory ventilator pressure is recorded and assisted ventilation is required (25).…”

Section: Discussionmentioning

confidence: 99%

The First Allogeneic Transplantation of Human Umbilical Cord-derived Mesenchymal Stem/stromal Cells for Bronchopulmonary Dysplasia: Preliminary Outcomes in Four Vietnamese Infants

Thanh

Hong

et al. 2020

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Abstract Background: Bronchopulmonary dysplasia (BPD) is a severe condition in premature infants that compromises theirlung function and necessitatesoxygen support. Despite major improvements in perinatal care minimizing the devastating effects, BPD remains the most frequent complication of extreme preterm birth. Our study reports the safety ofthe allogeneic administration of umbilical cord-derived mesenchymal stem/stromal cells (allo-UC-MSCs) and the preliminary efficacy of the treatment in four infants with established BPD.Methods: UC tissue was collected from a healthy donor, followed by propagation at the Stem Cell Core Facility at Vinmec Research Institute of Stem Cell and Gene Technology. UC-MSC culture was conducted under xeno-free and serum-free conditions. Four patients with established BPD were enrolled in this study between May 25, 2018, and December 31, 2018. All four patients received two intravenous doses of allo-UC-MSCs (1 million cells/kg patient body weight (PBW) per dose) with an intervening interval of 7 days. Safety and efficacy were evaluated during hospitalization and at 7 days and 1, 6 and 12 postdischargemonths.Results: No transplantation-associated severe adverse events or prespecified adverse events were observed in the four patients throughout the study period. At the time of this report, all patients had recovered from BPD and been weaned off of oxygen support. Chest X-rays and CT scans confirmed the dramatic reduction infibrosis.Conclusions: Allo-UC-MSC transplantation is safe and might improve respiratory function anddecrease lung fibrosis in preterm infants with established BPD.Trial registration: This preliminary study was approved by Vinmec International Hospital Ethics Board, approval number: 88/2019/QĐ-VMEC, registered 12 March 2019 - retrospectively registered.

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“…Sepsis was defined as clinical signs of infection with at least one positive blood or cerebrospinal fluid culture . Major congenital malformation includes malformations that are lethal or need specific diagnostic or therapeutic interventions during the neonatal period . Persistent pulmonary hypertension (PPH) was defined as marked postnatal pulmonary hypertension causing hypoxaemia requiring therapy .…”

Section: Methodsmentioning

confidence: 99%

Higher incidence of retinopathy of prematurity in extremely preterm infants associated with improved survival rates

et al. 2020

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Aim This study assessed possible reasons for the increasing incidence of retinopathy of prematurity (ROP) since mid‐2015 at our institution. Methods Retrospective analysis of all preterm infants born July 2013 to June 2017 with a gestational age (GA) <29 completed weeks admitted to the neonatal intensive care unit at the University Hospital Zurich during the first 28 days of life. The primary outcome measures were severest ROP stage. Statistical analysis was performed using generalised additive models in R. Results During the study period, survival increased in extremely preterm infants. Significant predictors for severest ROP stage were GA, days of mechanical ventilation and multiple gestation (P = .0322). A composite of severe comorbidities had no significant effect on severest ROP stage. GA was identified as the only significant risk factor the for severest ROP stage (P = .0045). Conclusion Increased survival rate of extremely preterm infants was associated with an increased incidence of ROP at our institution. Despite the increase, the incidence is still very low compared with other countries. No other additive factors were identified.

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Variability of Very Low Birth Weight Infant Outcome and Practice in Swiss and US Neonatal Units

Cited by 43 publications

References 35 publications

Risk factors of bronchopulmonary dysplasia in premature infants under 32 weeks of gestation: A retrospective case-control study

Risk factors of bronchopulmonary dysplasia in premature infants under 32 weeks of gestation: A retrospective case-control study

The First Allogeneic Transplantation of Human Umbilical Cord-derived Mesenchymal Stem/stromal Cells for Bronchopulmonary Dysplasia: Preliminary Outcomes in Four Vietnamese Infants

Higher incidence of retinopathy of prematurity in extremely preterm infants associated with improved survival rates

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