AUTHOR=Kim Hye-Rim , Jung Young Hwa , Kim Beyong Il , Kim So Young , Choi Chang Won 

TITLE=Differences in Comorbidities and Clinical Burden of Severe Bronchopulmonary Dysplasia Based on Disease Severity

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.664033

DOI=10.3389/fped.2021.664033

ISSN=2296-2360

ABSTRACT=Background
The present study compared baseline characteristics, comorbidities and clinical burden of preterm infants with type 1 and type 2 severe bronchopulmonary dysplasia (BPD) Collaborative classification.
Methods
This study was a prospective cohort study of preterm (<32 weeks) very-low-birth-weight infants. Severe BPD was divided into type 1 severe BPD requiring of ≥30% oxygen and/or noninvasive ventilation at 36 weeks postmenstrual age (PMA), and type 2 severe BPD requiring invasive mechanical ventilation at 36 weeks PMA. Baseline characteristics, comorbidities and clinical burden were compared between these two types of severe BPD. 
Results
Of the 1,328 infants included, 983 (74.0%) developed type 1 severe BPD, and 345 (26.0%) developed type 2 severe BPD. Lower birth weight, small for gestational age, lesser maternal premature rupture of membrane, lower 5-min Apgar score, air leak, pulmonary hemorrhage, surgical ligation of patent ductus arteriosus, necrotizing enterocolitis, and late-onset sepsis were significantly associated with type 2 severe BPD. Compared with infants with type 1 severe BPD, infants with type 2 severe BPD had an increased risk of mortality (aOR 18.64, 95% CI 10.81-32.13), pulmonary hypertension (aOR 2.16, 95% CI 1.59-2.93), and tracheostomy (aOR 10.38, 95% CI 2.05-52.49). 
Conclusions
Our data highlight the substantially greater mortality and clinical burden in infants with type 2 severe BPD than infants with type 1 severe BPD. A comprehensive and multidisciplinary approach is needed for infants with type 2 severe BPD.