Abstract:

Objective To explore the risk factors of bronchopulmonary dysplasia (BPD) in extremely preterm/low birth weight infants and to construct a logistic regression prediction model. Methods Medical records 140 ultra-premature infants/ultra-low birth weight infants hospitalized in Zhoukou Maternal and Child Health Hospital and the neonatal intensive care unit of Zhoukou Hospital of TCM from January 1, 2017 to December 31, 2023 were recruited. A total of 102 cases were finally included according to the inclusion and exclusion criteria. They were divided into BPD group and non-BPD group based on whether BPD occurred. The general data of the two groups were compared, and the pathological causes of ultra-premature infants/ultra-low birth weight infants were analyzed using logistic regression. Results A total of 102 ultra-premature/ultra-low birth weight infants were included in this study, and 59 of them developed BPD, with an incidence of 57.8%. Fetal conditions were as follows. Infants in the BPD group had significantly lower birth weight and gestational age, but higher proportions of 1-min Apgar≤7 points, neonatal pneumonia and neonatal sepsis, and longer mechanical ventilation time than those of the non-BPD group (P<0.05). Maternal conditions were as follows. The proportions of premature amniotic rupture>18 hours, and chorioamnionitis in the BPD group were significantly higher than those of the non-BPD group (P<0.05). Multivariate logistic regression analysis showed that gestational age and birth weight were independent protective factors for BPD in ultra-premature infants/ultra-low birth weight infants, and mechanical ventilation time and chorioamnionitis were independent risk factors for BPD in ultra-premature infants/ultra-low birth weight infants (P<0.05). Based on the results of multiple factors, a logistic regression risk prediction model was constructed. Logit (P) ranged from 0 to 1. The test results showed that the area under the curve (AUC) of the model in predicting extremely preterm/low birth weight infants with concurrent BPD was 0.891 (95%CI: 0.846-0.939), with the chi-square value (χ²) in the Hosmer-Lemeshow test of 6.543(P=0.072). Conclusion Birth weight, gestational age, duration of mechanical ventilation, and chorioamnionitis are all risk factors for the development of BPD in extremely preterm infants/very low birth weight infants. A logistic regression model based on these factors has high predictive value and can be used as an effective clinical model in predicting the occurrence of BPD. It also has certain guiding significance for subsequent clinical decisions.

Key words: bronchopulmonary dysplasia, ultra-preterm/ultra-low birth weight infants, logistic regression analysis, risk factor