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2017, Number 4

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Rev Med MD 2017; 8.9 (4)

Epidemiological profile of premature infants with bronchopulmonary dysplasia in a tertiary health care institution

García-Morales E, García-Camarena H, Angulo-Castellanos E, Reyes-Aguirre V, Barrera-De León JC, Hernández-Concha L, Jiménez-Uribe M, Gopar-Aguilar EC

Language: Spanish
References: 22
Page: 171-176
PDF size: 563.17 Kb.


ABSTRACT

Introduction. Bronchopulmonary dysplasia is an important cause of comorbidity in the ‹34 weeks of gestation preterm infant. Its incidence increases with decreasing gestational age and birth weight. The presence of bronchopulmonary dysplasia in preterm infants predicts multiple adverse outcomes; therefore it is important to determine the epidemiological characteristics related to risk factors in each care center. The present study aimed to describe the epidemiological characteristics of preterm infants ≤ 34 weeks of gestation and its association with bronchopulmonary dysplasia in a tertiary health care institution.
Material and Methods. This is an observational retrospective and analytical study performed at the “Fray Antonio Alcalde” Civil Hospital of Guadalajara from January to November 2016. We included 57 preterm infants. Neonates with and without bronchopulmonary dysplasia were identified. Gender, gestational age, birth weight, maternal age, gravid toxemia, smoking, chorioamnionitis, premature rupture of membranes, use of pulmonary maturators and/or caffeine, persistent ductus arteriosus, respiratory distress síndrome, mechanical ventilation, CPAP, oxygen use, surfactant, transfusions and/or sepsis were evaluated. Rates, Chi2 and odds ratios were obtained using SPSS software version 24.
Results. The frequency of bronchopulmonary dysplasia in preterm infants ≤34 weeks of gestation was 33.3%. Of the analyzed population, 63% were female. The average birth weight was 1080g (590-1760g). Differences with statistical significance were found in: gestational age (p‹0.010), respiratory distress syndrome (0R 18.41, CI 95% 3.65-92.77 p‹0.001), history of mechanical ventilation (OR 20, CI 95% 2.42- 165.28 p‹0.001), use Of surfactant (OR 18.41, CI 95% 3.65-92.77 p‹0.001), antecedent of transfusions (OR 6.87, CI 95% 1.99-23.71 p=0.001), diagnosis of sepsis (OR 1.31, CI 95% 1.09-1.56 p=0.021), positive acute phase reactants (OR 8.12, CI 95% 2.34-28.14 p‹0.001), age at discharge (p=0.040) and oxygen dependence (OR 1.81 ,CI 95% 1.35-2.40 p=0.001).
Discussion. The frequency of bronchopulmonary dysplasia was higher than that reported by countries with high economic potential but similar to that reported in other nations. The risk factors identified were similar to those previously described. There was greater prevalence in the female gender. The association between bronchopulmonary dysplasia and the history of transfusions was highlighted. It is suggested to carry out a case-control study to analyze confounding variables such as persistent ductus arteriosus, prenatal corticosteroids and the use of non-invasive ventilatory techniques.


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