Is the BPD epidemic diminishing?

Bobbi Byrne, Beverly G. Mellen, Daniel P. Lindstrom, Robert B. Cotton

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

In a previous study of very low birth weight neonates, ≤1500 g, admitted to the Vanderbilt University Neonatal Intensive Care Unit (NICU) from 1976-1990, improvements in survival were accompanied by a corresponding increase in the incidence of bronchopulmonary dysplasia (BPD). Since then, certain neonatal and perinatal interventions have been introduced and may influence neonatal outcomes. In this study, we have continued the analysis of the incidence of 3 outcomes: 1) Neonatal death (NEOD), 2) BPD, and 3) NEOD or BPD (NEOD/BPD) for an additional 7 years, 1991-1997. A retrospective study was performed of 3,837 patients with birth weight ≤1500 g and admitted to the Vanderbilt NICU within 24 hours of birth from 1976 through 1997. The outcomes NEOD, BPD, or NEOD/BPD were modeled by using multiple logistic regression with the following risk factors included as covariates: birth weight, gestational age, Apgar scores at 1 and 5 minutes, gender, race, birth location, diagnosis of hyaline membrane disease, maternal age, maternal diabetes, delivery method, multiple births, duration of ruptured membranes, and biologically relevant interactions among these covariates. To assess time trends in the risk factors and outcomes, patients were divided into time periods (1 = 1976-80, 2 = 1981-85, 3 = 1986-90, 4 = 1991-95, and 5 = 1996-97). For each outcome, only covariates or interactions among covariates found to be significant were retained in the final model. Adjusted odds ratios and 95% confidence intervals were calculated to measure the risk associated with a given time period in comparison to the preceding period. There was a progressive decline in NEOD across all time periods. The previously described increase in BPD from period 1 through period 3 is followed by a decrease in periods 4 and 5. The risk of NEOD/BPD remained fairly constant from period 1 to period 3, but then showed a significant decrease over the two most recent periods. Prior to 1991, the cost of improved survival among very low birth weight infants in this large NICU was an increased incidence of BPD. Since 1991, the risk of BPD has been decreasing even though survival continues to improve. If these findings are also representative of other NICUs, they signify an important reduction in the impact of BPD as one of the costly sequelae of prematurity.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalSeminars in Perinatology
Volume26
Issue number6
DOIs
StatePublished - Dec 2002
Externally publishedYes

Fingerprint

Bronchopulmonary Dysplasia
Neonatal Intensive Care Units
Very Low Birth Weight Infant
Birth Weight
Survival
Incidence
Parturition
Hyaline Membrane Disease
Multiple Birth Offspring
Apgar Score
Maternal Age
Gestational Age
Perinatal Death
Retrospective Studies
Logistic Models
Odds Ratio
Mothers
Newborn Infant
Confidence Intervals
Costs and Cost Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Byrne, B., Mellen, B. G., Lindstrom, D. P., & Cotton, R. B. (2002). Is the BPD epidemic diminishing? Seminars in Perinatology, 26(6), 461-466. https://doi.org/10.1053/sper.2002.37147

Is the BPD epidemic diminishing? / Byrne, Bobbi; Mellen, Beverly G.; Lindstrom, Daniel P.; Cotton, Robert B.

In: Seminars in Perinatology, Vol. 26, No. 6, 12.2002, p. 461-466.

Research output: Contribution to journalArticle

Byrne, B, Mellen, BG, Lindstrom, DP & Cotton, RB 2002, 'Is the BPD epidemic diminishing?', Seminars in Perinatology, vol. 26, no. 6, pp. 461-466. https://doi.org/10.1053/sper.2002.37147
Byrne, Bobbi ; Mellen, Beverly G. ; Lindstrom, Daniel P. ; Cotton, Robert B. / Is the BPD epidemic diminishing?. In: Seminars in Perinatology. 2002 ; Vol. 26, No. 6. pp. 461-466.
@article{6583994f10df433e8df850c53dc84569,
title = "Is the BPD epidemic diminishing?",
abstract = "In a previous study of very low birth weight neonates, ≤1500 g, admitted to the Vanderbilt University Neonatal Intensive Care Unit (NICU) from 1976-1990, improvements in survival were accompanied by a corresponding increase in the incidence of bronchopulmonary dysplasia (BPD). Since then, certain neonatal and perinatal interventions have been introduced and may influence neonatal outcomes. In this study, we have continued the analysis of the incidence of 3 outcomes: 1) Neonatal death (NEOD), 2) BPD, and 3) NEOD or BPD (NEOD/BPD) for an additional 7 years, 1991-1997. A retrospective study was performed of 3,837 patients with birth weight ≤1500 g and admitted to the Vanderbilt NICU within 24 hours of birth from 1976 through 1997. The outcomes NEOD, BPD, or NEOD/BPD were modeled by using multiple logistic regression with the following risk factors included as covariates: birth weight, gestational age, Apgar scores at 1 and 5 minutes, gender, race, birth location, diagnosis of hyaline membrane disease, maternal age, maternal diabetes, delivery method, multiple births, duration of ruptured membranes, and biologically relevant interactions among these covariates. To assess time trends in the risk factors and outcomes, patients were divided into time periods (1 = 1976-80, 2 = 1981-85, 3 = 1986-90, 4 = 1991-95, and 5 = 1996-97). For each outcome, only covariates or interactions among covariates found to be significant were retained in the final model. Adjusted odds ratios and 95{\%} confidence intervals were calculated to measure the risk associated with a given time period in comparison to the preceding period. There was a progressive decline in NEOD across all time periods. The previously described increase in BPD from period 1 through period 3 is followed by a decrease in periods 4 and 5. The risk of NEOD/BPD remained fairly constant from period 1 to period 3, but then showed a significant decrease over the two most recent periods. Prior to 1991, the cost of improved survival among very low birth weight infants in this large NICU was an increased incidence of BPD. Since 1991, the risk of BPD has been decreasing even though survival continues to improve. If these findings are also representative of other NICUs, they signify an important reduction in the impact of BPD as one of the costly sequelae of prematurity.",
author = "Bobbi Byrne and Mellen, {Beverly G.} and Lindstrom, {Daniel P.} and Cotton, {Robert B.}",
year = "2002",
month = "12",
doi = "10.1053/sper.2002.37147",
language = "English (US)",
volume = "26",
pages = "461--466",
journal = "Seminars in Perinatology",
issn = "0146-0005",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Is the BPD epidemic diminishing?

AU - Byrne, Bobbi

AU - Mellen, Beverly G.

AU - Lindstrom, Daniel P.

AU - Cotton, Robert B.

PY - 2002/12

Y1 - 2002/12

N2 - In a previous study of very low birth weight neonates, ≤1500 g, admitted to the Vanderbilt University Neonatal Intensive Care Unit (NICU) from 1976-1990, improvements in survival were accompanied by a corresponding increase in the incidence of bronchopulmonary dysplasia (BPD). Since then, certain neonatal and perinatal interventions have been introduced and may influence neonatal outcomes. In this study, we have continued the analysis of the incidence of 3 outcomes: 1) Neonatal death (NEOD), 2) BPD, and 3) NEOD or BPD (NEOD/BPD) for an additional 7 years, 1991-1997. A retrospective study was performed of 3,837 patients with birth weight ≤1500 g and admitted to the Vanderbilt NICU within 24 hours of birth from 1976 through 1997. The outcomes NEOD, BPD, or NEOD/BPD were modeled by using multiple logistic regression with the following risk factors included as covariates: birth weight, gestational age, Apgar scores at 1 and 5 minutes, gender, race, birth location, diagnosis of hyaline membrane disease, maternal age, maternal diabetes, delivery method, multiple births, duration of ruptured membranes, and biologically relevant interactions among these covariates. To assess time trends in the risk factors and outcomes, patients were divided into time periods (1 = 1976-80, 2 = 1981-85, 3 = 1986-90, 4 = 1991-95, and 5 = 1996-97). For each outcome, only covariates or interactions among covariates found to be significant were retained in the final model. Adjusted odds ratios and 95% confidence intervals were calculated to measure the risk associated with a given time period in comparison to the preceding period. There was a progressive decline in NEOD across all time periods. The previously described increase in BPD from period 1 through period 3 is followed by a decrease in periods 4 and 5. The risk of NEOD/BPD remained fairly constant from period 1 to period 3, but then showed a significant decrease over the two most recent periods. Prior to 1991, the cost of improved survival among very low birth weight infants in this large NICU was an increased incidence of BPD. Since 1991, the risk of BPD has been decreasing even though survival continues to improve. If these findings are also representative of other NICUs, they signify an important reduction in the impact of BPD as one of the costly sequelae of prematurity.

AB - In a previous study of very low birth weight neonates, ≤1500 g, admitted to the Vanderbilt University Neonatal Intensive Care Unit (NICU) from 1976-1990, improvements in survival were accompanied by a corresponding increase in the incidence of bronchopulmonary dysplasia (BPD). Since then, certain neonatal and perinatal interventions have been introduced and may influence neonatal outcomes. In this study, we have continued the analysis of the incidence of 3 outcomes: 1) Neonatal death (NEOD), 2) BPD, and 3) NEOD or BPD (NEOD/BPD) for an additional 7 years, 1991-1997. A retrospective study was performed of 3,837 patients with birth weight ≤1500 g and admitted to the Vanderbilt NICU within 24 hours of birth from 1976 through 1997. The outcomes NEOD, BPD, or NEOD/BPD were modeled by using multiple logistic regression with the following risk factors included as covariates: birth weight, gestational age, Apgar scores at 1 and 5 minutes, gender, race, birth location, diagnosis of hyaline membrane disease, maternal age, maternal diabetes, delivery method, multiple births, duration of ruptured membranes, and biologically relevant interactions among these covariates. To assess time trends in the risk factors and outcomes, patients were divided into time periods (1 = 1976-80, 2 = 1981-85, 3 = 1986-90, 4 = 1991-95, and 5 = 1996-97). For each outcome, only covariates or interactions among covariates found to be significant were retained in the final model. Adjusted odds ratios and 95% confidence intervals were calculated to measure the risk associated with a given time period in comparison to the preceding period. There was a progressive decline in NEOD across all time periods. The previously described increase in BPD from period 1 through period 3 is followed by a decrease in periods 4 and 5. The risk of NEOD/BPD remained fairly constant from period 1 to period 3, but then showed a significant decrease over the two most recent periods. Prior to 1991, the cost of improved survival among very low birth weight infants in this large NICU was an increased incidence of BPD. Since 1991, the risk of BPD has been decreasing even though survival continues to improve. If these findings are also representative of other NICUs, they signify an important reduction in the impact of BPD as one of the costly sequelae of prematurity.

UR - http://www.scopus.com/inward/record.url?scp=12244267071&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12244267071&partnerID=8YFLogxK

U2 - 10.1053/sper.2002.37147

DO - 10.1053/sper.2002.37147

M3 - Article

C2 - 12537319

AN - SCOPUS:12244267071

VL - 26

SP - 461

EP - 466

JO - Seminars in Perinatology

JF - Seminars in Perinatology

SN - 0146-0005

IS - 6

ER -