Pediatric pulmonology · 2025
Bronchopulmonary Dysplasia in the First Year: Insights Into Severity, Medication Use, and Healthcare Utilization.
СтатьяНазвание и аннотация: Перевод в очереди
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Brumer Eliaz, Shabanova Veronika, Urbach Haley, Montgomery Angela, Grossman Matthew, Chen Laura, Weiss Pnina, Kandil Sarah
Аннотация
BACKGROUND AND OBJECTIVES: Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants. This study aimed to (1) examine associations between BPD severity and respiratory outcomes and healthcare utilization; (2) evaluate the impact of outpatient pediatric pulmonology follow-up; and (3) assess whether dexamethasone administration during NICU stay influences postdischarge respiratory morbidity.
METHODS: This retrospective cohort study included 161 infants diagnosed with BPD (2021-2023) using the 2019 BPD severity classification. Key outcomes included the prevalence of prescriptions for albuterol, inhaled corticosteroid, and systemic steroids, as well as ED visits and admission within the first-year postdischarge. The study analyzed associations between dexamethasone use during NICU admission, outpatient pulmonology follow-ups, and respiratory morbidity.
RESULTS: Of 161 infants, 32.9% had grade-1, 59.0% grade-2, and 8.1% grade-3 BPD. Dexamethasone administration during NICU admission increased with BPD severity (p < 0.001). Pediatric pulmonology follow-up was common in grade-2 (77.9%) and grade-3 (84.6%) but lower in grade-1 (47.2%, p < 0.001). Use of inhaled medications and systemic steroids varied significantly by severity. Nearly half of the cohort (47.2%) had a hospital visit for respiratory issues postdischarge, and 22.3% required hospitalization.
CONCLUSION: This study characterizes respiratory outcomes and healthcare utilization in infants with BPD during the first-year post-NICU discharge. While morbidity and healthcare utilization increased with BPD severity, nearly half of the entire cohort required hospital visits, underscoring a significant disease burden even among infants with milder disease. These findings highlight the importance of structured longitudinal follow-up across all BPD severity levels.
METHODS: This retrospective cohort study included 161 infants diagnosed with BPD (2021-2023) using the 2019 BPD severity classification. Key outcomes included the prevalence of prescriptions for albuterol, inhaled corticosteroid, and systemic steroids, as well as ED visits and admission within the first-year postdischarge. The study analyzed associations between dexamethasone use during NICU admission, outpatient pulmonology follow-ups, and respiratory morbidity.
RESULTS: Of 161 infants, 32.9% had grade-1, 59.0% grade-2, and 8.1% grade-3 BPD. Dexamethasone administration during NICU admission increased with BPD severity (p < 0.001). Pediatric pulmonology follow-up was common in grade-2 (77.9%) and grade-3 (84.6%) but lower in grade-1 (47.2%, p < 0.001). Use of inhaled medications and systemic steroids varied significantly by severity. Nearly half of the cohort (47.2%) had a hospital visit for respiratory issues postdischarge, and 22.3% required hospitalization.
CONCLUSION: This study characterizes respiratory outcomes and healthcare utilization in infants with BPD during the first-year post-NICU discharge. While morbidity and healthcare utilization increased with BPD severity, nearly half of the entire cohort required hospital visits, underscoring a significant disease burden even among infants with milder disease. These findings highlight the importance of structured longitudinal follow-up across all BPD severity levels.