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Am J Respir Crit Care Med. 2011 Jun 15;183(12):1715-22. doi: 10.1164/rccm.201101-0055OC. Epub 2011 Mar 4.

Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants.

Collaborators (149)

Jobe AH, Caplan MS, Oh W, Hensman AM, Gingras D, Barnett S, Lillie S, Francis K, Andrews D, Angela K, Fanaroff AA, Siner BS, Neuhauser D, Clarke L, Donovan EF, Narendran V, Bridges K, Alexander B, Grisby C, Mersmann MW, Mincey HL, Hessling J, Goldberg RN, Auten KJ, Fisher KA, Foy KA, Siaw G, Piazza A, Carlton DP, Hale EC, Bishop MB, Seabrook I, Archer SW, Poindexter BB, Lemons JA, Engle WA, Hamer F, Herron DE, Hooper R, Miller LC, Wilson LD, Berberich MA, Blaisdell CJ, Gail DB, Kiley JP, Poole WK, Cunningham M, Hastings BK, Irene AR, Auman JO, Huitema CP, Auman JO, Pickett JW, Schaefer SE, Wallace D, Yao Q, Zaterka-Baxter KM, Stevenson DK, Ball M, Proud MS, Rhine WD, Kibler C, Parker JR, Frantz ID 3rd, Fiascone JM, Furey A, MacKinnon BL, Nylen E, Collins MV, Cosby SS, Phillips VA, Rhine W, Rasmussen MR, Wozniak PR, Rich W, Heldt G, Grabarczyk M, Joseph C, Arnell K, Bridge R, Demetrio C, Goodmar J, Henderson C, Bell EF, Widness JA, Klein JM, Johnson KJ, Krutzfield NJ, Duara S, Bauer CR, Everett-Thomas R, Worth AM, Watterberg KL, Ohls RK, Rohr J, Lacy CB, Laroia N, Phelps DL, Sinkin RA, Reubens LJ, Rowan M, Burnell E, Tyson JE, Morris BH, Harris BF, Lis AE, Martin S, McDavid GE, Wright SL, Akpa EG, Cluff PA, Franco CI, Tate PL, Sánchez PJ, Salhab WA, Rosenfeld CR, Brion LP, Allen J, Guzman A, Hensley G, Leps MH, Madison S, Martin M, Miller NA, Solis A, Vasil DM, Wilder K, Burnett J, Jensen JJ, Osborne KA, Spencer C, Weaver-Lewis K, O'Shea T, Peters NJ, Sood BG, Kazzi S, Bara R, Batts M, Billian E, Hayes-Hart K, Johnson M, Muran G, Bhandari V, Jacobs HC, Cervone P, Gettner P, Konstantino M, Poulsen J, Taft J.

Author information

1
Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina 27599-7596, USA. matt_laughon@med.unc.edu

Abstract

RATIONALE:

Benefits of identifying risk factors for bronchopulmonary dysplasia in extremely premature infants include providing prognostic information, identifying infants likely to benefit from preventive strategies, and stratifying infants for clinical trial enrollment.

OBJECTIVES:

To identify risk factors for bronchopulmonary dysplasia, and the competing outcome of death, by postnatal day; to identify which risk factors improve prediction; and to develop a Web-based estimator using readily available clinical information to predict risk of bronchopulmonary dysplasia or death.

METHODS:

We assessed infants of 23-30 weeks' gestation born in 17 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and enrolled in the Neonatal Research Network Benchmarking Trial from 2000-2004.

MEASUREMENTS AND MAIN RESULTS:

Bronchopulmonary dysplasia was defined as a categorical variable (none, mild, moderate, or severe). We developed and validated models for bronchopulmonary dysplasia risk at six postnatal ages using gestational age, birth weight, race and ethnicity, sex, respiratory support, and Fi(O(2)), and examined the models using a C statistic (area under the curve). A total of 3,636 infants were eligible for this study. Prediction improved with advancing postnatal age, increasing from a C statistic of 0.793 on Day 1 to a maximum of 0.854 on Day 28. On Postnatal Days 1 and 3, gestational age best improved outcome prediction; on Postnatal Days 7, 14, 21, and 28, type of respiratory support did so. A Web-based model providing predicted estimates for bronchopulmonary dysplasia by postnatal day is available at https://neonatal.rti.org.

CONCLUSIONS:

The probability of bronchopulmonary dysplasia in extremely premature infants can be determined accurately using a limited amount of readily available clinical information.

PMID:
21471086
PMCID:
PMC3136997
DOI:
10.1164/rccm.201101-0055OC
[Indexed for MEDLINE]
Free PMC Article

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