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

Publication ,  Journal Article
Laughon, MM; Langer, JC; Bose, CL; Smith, PB; Ambalavanan, N; Kennedy, KA; Stoll, BJ; Buchter, S; Laptook, AR; Ehrenkranz, RA; Cotten, CM ...
Published in: Am J Respir Crit Care Med
June 15, 2011

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.

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Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

June 15, 2011

Volume

183

Issue

12

Start / End Page

1715 / 1722

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Respiratory System
  • Racial Groups
  • Models, Statistical
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Gestational Age
 

Citation

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Laughon, M. M., Langer, J. C., Bose, C. L., Smith, P. B., Ambalavanan, N., Kennedy, K. A., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, . (2011). Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med, 183(12), 1715–1722. https://doi.org/10.1164/rccm.201101-0055OC
Laughon, Matthew M., John C. Langer, Carl L. Bose, P Brian Smith, Namasivayam Ambalavanan, Kathleen A. Kennedy, Barbara J. Stoll, et al. “Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants.Am J Respir Crit Care Med 183, no. 12 (June 15, 2011): 1715–22. https://doi.org/10.1164/rccm.201101-0055OC.
Laughon MM, Langer JC, Bose CL, Smith PB, Ambalavanan N, Kennedy KA, et al. Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med. 2011 Jun 15;183(12):1715–22.
Laughon, Matthew M., et al. “Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants.Am J Respir Crit Care Med, vol. 183, no. 12, June 2011, pp. 1715–22. Pubmed, doi:10.1164/rccm.201101-0055OC.
Laughon MM, Langer JC, Bose CL, Smith PB, Ambalavanan N, Kennedy KA, Stoll BJ, Buchter S, Laptook AR, Ehrenkranz RA, Cotten CM, Wilson-Costello DE, Shankaran S, Van Meurs KP, Davis AS, Gantz MG, Finer NN, Yoder BA, Faix RG, Carlo WA, Schibler KR, Newman NS, Rich W, Das A, Higgins RD, Walsh MC, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med. 2011 Jun 15;183(12):1715–1722.

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

June 15, 2011

Volume

183

Issue

12

Start / End Page

1715 / 1722

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Respiratory System
  • Racial Groups
  • Models, Statistical
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Newborn
  • Humans
  • Gestational Age