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Premature infants less than 33 weeks gestational age (GA) with bronchopulmonary dysplasia (BPD) are rehospitalized at more than twice the rate of similarly premature infants without BPD, according to a study supported in part by the Agency for Healthcare Research and Quality (T32 HS00063). Bronchopulmonary dysplasia (BPD), which affects many low birthweight and premature babies, is marked by abnormal lung x-rays, respiratory compromise, and prolonged oxygen requirement. Because infants with BPD continue to have lung function abnormalities and may have subclinical lung damage long past the neonatal period, they often are more susceptible to respiratory infections (for example, from respiratory syncytial virus, RSV) and bronchospastic conditions that can lead to hospitalization.
The goal of the study, which was conducted by Vincent C. Smith, M.D., M.P.H., of the Harvard School of Public Health, and his colleagues, was to describe rates and identify risk factors for rehospitalization during the first year of life among infants with BPD. They retrospectively analyzed rates of BPD and rehospitalization for any reason before the first birthday among a group of infants born less than 33 weeks GA between 1995 and 1999. They defined BPD as needing supplemental oxygen and/or mechanical ventilation at 36 weeks corrected GA. About 15 percent of the infants studied had BPD. In the first year of life, 49 percent of infants with BPD (118 of 238) were rehospitalized, a rate more than twice that of non-BPD infants (23 percent, 309 of 1,359).
The researchers found no clinical or demographic factors that predicted rehospitalization of premature infants with BPD. No measured demographic or physiologic factors discriminated between those infants with BPD who were and were not rehospitalized, even when only rehospitalizations for respiratory diagnoses were considered. Other factors that could be linked to rehospitalization of infants with BPD, such as air quality of the home environment, passive smoking exposure, RSV prophylaxis, breast feeding status, and/or parenting and primary care management styles, should be examined in future studies, conclude the researchers.
See "Rehospitalization in the first year of life among infants with bronchopulmonary dysplasia," by Dr. Smith, John A. Zupancic, M.D., Sc.D., Marie C. McCormick, M.D., Sc.D., and others, in the June 2004 Journal of Pediatrics 144, pp. 799-803.
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