Pediatrics international : official journal of the Japan Pediatric Society · 2026
Chronic Lung Disease: A Study Based on the National Database of Specified Chronic Pediatric Diseases of Japan.
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Namba Fumihiko
Аннотация
BACKGROUND: Chronic lung disease (CLD), commonly recognized as bronchopulmonary dysplasia and primarily associated with prematurity and low birth weight, is designated as a specified chronic pediatric disease in Japan. However, the characteristics of children registered in the National Database of Specified Chronic Pediatric Diseases have not been fully elucidated.
METHODS: With approval from the Ethics Committee of Saitama Medical Center, Saitama Medical University, and the Third-Party Data Provision Office for Patients with Intractable Diseases, we analyzed data from Medical Certificates of Specific Chronic Pediatric Diseases for patients with CLD registered between January 2015 and March 2023.
RESULTS: A total of 1737 patients with CLD were identified. Extremely preterm infants and term infants accounted for 47% and 24% of cases, respectively, with marked regional variation in gestational age distribution. Among 410 registered term infants, neurological disorders (43%) and chromosomal abnormalities (19%) were the most common underlying conditions. With increasing age, the proportion of extremely preterm infants decreased, whereas that of term infants increased. In a subgroup analysis of 805 extremely preterm infants, invasive mechanical ventilation at 36 weeks' postmenstrual age was independently associated with persistent registration within the chronic disease support program (odds ratio 3.16, 95% CI 1.81-5.52; p < 0.001).
CONCLUSIONS: This nationwide registry study demonstrates that registry-defined CLD in Japan represents a heterogeneous population, including a substantial number of term infants with diverse comorbidities. Among extremely preterm infants, the need for invasive respiratory support at 36 weeks' postmenstrual age was associated with persistent registration within the chronic disease support program, underscoring the importance of optimizing long-term management strategies.
METHODS: With approval from the Ethics Committee of Saitama Medical Center, Saitama Medical University, and the Third-Party Data Provision Office for Patients with Intractable Diseases, we analyzed data from Medical Certificates of Specific Chronic Pediatric Diseases for patients with CLD registered between January 2015 and March 2023.
RESULTS: A total of 1737 patients with CLD were identified. Extremely preterm infants and term infants accounted for 47% and 24% of cases, respectively, with marked regional variation in gestational age distribution. Among 410 registered term infants, neurological disorders (43%) and chromosomal abnormalities (19%) were the most common underlying conditions. With increasing age, the proportion of extremely preterm infants decreased, whereas that of term infants increased. In a subgroup analysis of 805 extremely preterm infants, invasive mechanical ventilation at 36 weeks' postmenstrual age was independently associated with persistent registration within the chronic disease support program (odds ratio 3.16, 95% CI 1.81-5.52; p < 0.001).
CONCLUSIONS: This nationwide registry study demonstrates that registry-defined CLD in Japan represents a heterogeneous population, including a substantial number of term infants with diverse comorbidities. Among extremely preterm infants, the need for invasive respiratory support at 36 weeks' postmenstrual age was associated with persistent registration within the chronic disease support program, underscoring the importance of optimizing long-term management strategies.