Point Prevalence, Clinical Characteristics, and Treatment Variation for Infants with Severe Bronchopulmonary Dysplasia

Am J Perinatol. 2015 Aug;32(10):960-7. doi: 10.1055/s-0035-1547326. Epub 2015 Mar 4.


Objectives: Despite improvements in survival of preterm infants, bronchopulmonary dysplasia (BPD) remains a persistent morbidity. The incidence, clinical course, and current management of severe BPD (sBPD) remain to be defined. To address these knowledge gaps, a multicenter collaborative was formed to improve outcomes in this population.

Study design: We performed a "snapshot" in eight neonatal intensive care units (NICUs) on December 17, 2013. A standardized clinical data form for each inpatient born at < 32 weeks was completed and collated centrally for analysis. sBPD was defined as receiving ≥ 30% supplemental oxygen and/or receiving positive pressure ventilation at 36 weeks postmenstrual age (PMA).

Results: Of a total census of 710 inpatients, 351 infants were born at < 32 weeks and 128 of those (36.5%) met criteria for sBPD. The point prevalence of sBPD varied between centers (11-58%; p < 0.001). Among infants with sBPD there was a variation among centers in the use of mechanical ventilation at 28 days of life (p < 0.001) and at 36 weeks PMA (p = 0.001). We observed differences in the use of diuretics (p = 0.018), inhaled corticosteroids (p < 0.001), and inhaled β-agonists (p < 0.001).

Conclusion: The high point prevalence of sBPD and variable management among NICUs emphasizes the lack of evidence in guiding optimal care to improve long-term outcomes of this high-risk, understudied population.

Publication types

  • Multicenter Study

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / therapeutic use*
  • Adrenergic beta-Agonists / therapeutic use*
  • Bronchopulmonary Dysplasia / epidemiology
  • Bronchopulmonary Dysplasia / therapy*
  • Disease Management
  • Diuretics / therapeutic use*
  • Female
  • Fundoplication / statistics & numerical data
  • Gastrostomy / statistics & numerical data
  • Humans
  • Hypertension, Pulmonary / epidemiology
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Oxygen Inhalation Therapy / methods
  • Positive-Pressure Respiration / methods*
  • Prevalence
  • Severity of Illness Index
  • Tracheostomy / statistics & numerical data


  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Diuretics