Clinical Predictors of Bronchopulmonary Dysplasia in Very Preterm Infants

Abstract

Background: Bronchopulmonary dysplasia (BPD) remains one of the most common chronic respiratory complications among very preterm infants and is associated with significant neonatal morbidity, prolonged hospitalization, impaired neurodevelopment, and increased healthcare utilization. Improvements in neonatal intensive care have enhanced survival among extremely preterm infants; however, the incidence of BPD continues to be substantial. Early identification of infants at increased risk may facilitate targeted preventive strategies and optimize neonatal outcomes. Aim: To identify the clinical predictors associated with the development of bronchopulmonary dysplasia in very preterm infants admitted to the Neonatal Intensive Care Unit (NICU) of Rajendra Institute of Medical Sciences, Ranchi. Materials and Methods: A retrospective cohort study was conducted over 24 months in the Department of Neonatology, Rajendra Institute of Medical Sciences, Ranchi. Fifty very preterm infants meeting the eligibility criteria were included. Maternal, perinatal, and neonatal clinical data were retrieved from hospital records. Variables including gestational age, birth weight, sex, antenatal corticosteroid exposure, surfactant therapy, respiratory support, oxygen therapy duration, sepsis, patent ductus arteriosus, and other neonatal complications were evaluated. Bronchopulmonary dysplasia was diagnosed according to established National Institute of Child Health and Human Development (NICHD) criteria. Statistical analysis was performed using appropriate descriptive and inferential methods to identify factors associated with BPD. Results: Clinical characteristics of very preterm infants were compared according to the presence or absence of bronchopulmonary dysplasia. Maternal, perinatal, and neonatal variables were evaluated to identify potential predictors, and multivariable regression analysis was performed to determine independent risk factors associated with BPD development. Conclusion: Early recognition of clinical predictors may facilitate timely intervention, individualized respiratory management, and optimization of neonatal outcomes. Identification of modifiable risk factors could contribute to improved preventive strategies and reduced morbidity among very preterm infants. Keywords: Bronchopulmonary dysplasia, Very preterm infants, Prematurity, Neonatal intensive care, Respiratory distress syndrome, Risk factors.