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BMC Pediatr. 2017 May 15;17(1):125. doi: 10.1186/s12887-017-0881-1.

Interstitial pneumonia pattern on day 7 chest radiograph predicts bronchopulmonary dysplasia in preterm infants.

Kim HR1,2,3, Kim JY4, Yun B4, Lee B5, Choi CW6,7, Kim BI2,3.

Author information

1
Department of Pediatrics, Bundang CHA Medical Center, CHA University, Seongnam, Republic of Korea.
2
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
3
Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
4
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
5
Department of Pediatrics, Wonju Severance Christian Hospital, Wonju, Republic of Korea.
6
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea. choicw@snu.ac.kr.
7
Department of Pediatrics, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea. choicw@snu.ac.kr.

Abstract

BACKGROUND:

Early identification of infants at higher risk of developing bronchopulmonary dysplasia (BPD) may enable a targeted approach to reduce BPD. We aimed to evaluate the hypothesis that the interstitial pneumonia pattern on the day 7 chest radiograph predicts BPD or death before 36 weeks postmenstrual age (PMA).

METHODS:

A retrospective cohort study was performed on 336 preterm infants (birth weight < 1500 g and gestational age < 32 postmenstrual weeks) who were admitted to a single tertiary academic center between January 2008 and December 2014. Day 7 chest radiographs were independently reviewed by two pediatric radiologists who were unaware of the clinical information regarding each individual infant.

RESULTS:

Data from 304 infants who survived more than 7 days after birth were collected. The interstitial pneumonia pattern on the day 7 chest radiograph was independently associated with BPD or death before 36 weeks PMA (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.1-14.4). The interstitial pneumonia pattern on the day 7 chest radiograph predicted BPD or death with a specificity of 98%. Histologic chorioamnionitis was a preceding factor that was independently associated with the interstitial pneumonia pattern on the day 7 chest radiograph (OR 3.7, 95% CI 1.3-10.3).

CONCLUSIONS:

The interstitial pneumonia pattern on the day 7 chest radiograph has a high specificity for predicting BPD or death and can be utilized to select high-risk preterm infants who will benefit from potentially preventive interventions against BPD.

KEYWORDS:

Bronchopulmonary dysplasia; Chest radiograph; Interstitial pneumonia; Predictor

PMID:
28506211
PMCID:
PMC5433188
DOI:
10.1186/s12887-017-0881-1
[Indexed for MEDLINE]
Free PMC Article

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