Factors Influencing Bronchopulmonary Dysplasia: An Eight-Year Study in a Single Tertiary Care Unit in Thailand

Abstract

Objective: To assess the incidence trends of severe BPD or death, identify associated risk factors, and develop a predictive model using Jensen’s BPD grading system. Materials and Methods: This retrospective study included infants with a gestational age (GA) < 32 weeks born between 2013 and 2020. Infants were classified into no BPD and BPD (all grades) or death categories. Risk factors and a predictive model for outcomes were identified using multivariable logistic regression and evaluated with a receiver operating characteristic (ROC) curve. Results: Among the 772 infants, 286 (37%) were classified into the BPD group. The incidence of BPD continuously increased from 16.3% in 2013 to 49.4% in 2020. Multivariate analyses revealed factors associated with severe BPD, including IUGR, the 1-minute Apgar score, surfactant administration, late-onset sepsis, hydrocortisone, PDA ligation, postnatal steroid and mechanical ventilation (MV) days. The highest adjusted odds ratio (aOR) was for MV?> 42 days at 19.29 (95% CI; 7.22–51.55; p<0.001). The area under the curve (AUC) was 0.898, with 80.68% sensitivity and 84.83% specificity. Conclusion: When Jensen’s criteria were used, the incidence and risk factors for severe BPD or death in Thai neonates were similar to those reported in previous studies. The regression model exhibited good predictive value, potentially assisting clinicians in targeted interventions.