Clinical characteristics and respiratory management of bronchopulmonary dysplasia in preterm infants: a retrospective case-control study.

OBJECTIVE

Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants, and early recognition of clinical risk factors facilitates risk prediction.

METHODS

This retrospective case-control study included preterm infants admitted with BPD diagnosed and classified as mild, moderate or severe. Data were collected on perinatal characteristics, maternal factors, respiratory support, early arterial blood gas and haematologic markers and hospitalisation complications.

RESULTS

Among 410 preterm infants, 210 developed BPD and 200 did not. Infants with BPD had lower gestational age (29.36 ± 2.04 vs. 30.15 ± 1.69 weeks, P < 0.001) and longer hospital stays (57.65 ± 21.08 vs. 50.03 ± 17.32 days, P < 0.001). They required significantly longer total mechanical ventilation, including invasive and non-invasive support (349.67 ± 375.76 vs. 227.03 ± 239.33 h, P < 0.001), which increased with disease severity, and re-initiation of ventilation was more frequent (32.4% vs. 16.5%, P < 0.001). The BPD group exhibited lower base excess and higher lactate levels, accompanied by reduced haemoglobin and haematocrit (all P < 0.05). Maternal complications, including premature rupture of membranes, hypertensive disorders, gestational diabetes and antenatal infections, were more common in the BPD group, whose infants also showed higher rates of neonatal complications, particularly anaemia and neonatal respiratory distress syndrome. Mortality remained low but was slightly higher in the BPD group (1.5% vs. 1.0%).

CONCLUSIONS

Bronchopulmonary dysplasia in preterm infants is linked to lower gestational age, adverse maternal factors and a higher rate of complications. Prolonged ventilation demonstrates a strong descriptive association reflecting disease severity and the clinical course, highlighting the need for early risk identification and individualised management.