J Formos Med Assoc. 2025 Nov 19:S0929-6646(25)00594-7. doi: 10.1016/j.jfma.2025.11.005. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to compare various respiratory therapies for diagnosing bronchopulmonary dysplasia (BPD) at different postmenstrual ages (PMA), and to undertake a retrospective review at the adverse respiratory outcomes at preschool age to identify the optimal predictors.
METHODS: This retrospective cohort study was conducted at a tertiary neonatal intensive care unit enrolling preterm very-low-birth-weight (VLBW) infants. Respiratory status was classified based on modes of respiratory therapy required (supplemental oxygen, oxygen, and/or positive-pressure respiratory support [oxygen/PRS], and PRS alone) at the prespecified time points. The frequency of preschool-age pulmonary morbidity, defined as either a Z-score lower than -1.64 on any lung function test, or a diagnosis of asthma and/or at least three admissions for respiratory causes, was compared using regression models, assessing the predictive values of these respiratory supports.
RESULTS: Of the 70 VLBW neonates born at a mean gestational age of 27.6 weeks, 57.1 % had composite respiratory morbidities at follow-up. Among the respiratory support modes, oxygen use at 36 and 40 weeks’, oxygen/PRS at 36 and 40 weeks’, and PRS alone at 36 weeks PMA were significantly associated with undesirable outcomes. Oxygen/PRS use at 36 weeks’ PMA showed a numerically higher effect estimate for predicting the effect and area under the curve (AUC) (adjusted odds ratio 7.46, P = 0.01; AUC 0.841).
CONCLUSIONS: Supplemental oxygen and/or positive-pressure respiratory support are good predictors of respiratory morbidity. Thirty-six weeks’ PMA appears to be a clinically relevant time point for predicting future pulmonary outcomes in this cohort.
PMID:41266152 | DOI:10.1016/j.jfma.2025.11.005
