The following is a summary of “Definitions of Bronchopulmonary Dysplasia: Which One Should We Use?” published in the December 2022 issue of Pediatrics by Pérez-Tarazona et al.
For a study, researchers sought to determine if the existing criteria of bronchopulmonary dysplasia (BPD) were clinically applicable and whether they may be used to forecast future respiratory outcomes.
Data from 104 preterm babies (mean gestational age, 25.8 weeks) who received a BPD diagnosis between 2010 and 2018 at a single tertiary care facility were gathered for the retrospective cohort analysis. The newborns were categorized using the following criteria: 2001 National Institute of Child Health and Human Development (NICHD), 2017 Canadian Neonatal Network (CNN), 2018 NICHD, and 2019 Neonatal Research Network (NRN). To evaluate each definition’s capacity for predicting death or severe respiratory morbidity at ages 18 to 24 months, logistic regression and the area under the receiver operating characteristic curve (AUC) were utilized.
With the exception of the 2001 NICHD definition, which included 11.4% of patients who couldn’t be classified, all patients could be accurately categorized by each criterion. According to the 2017 CNN definition, BPD prevalence was 49%, while according to the 2018 NICHD and 2019 NRN definitions, it was 70%. The 2018 NICHD definition had an accuracy of 85.6% and a significantly higher AUC when compared to the 2001 NICHD (0.891 vs. 0.824; P =.015) and 2017 CNN (0.891 vs. 0.811; P =.036) definitions, but not when compared to the 2019 NRN definition (0.891 vs. 0.833; P =.09), was the best regression model.
The 2018 NICHD definition had the best mid-term respiratory outcome prediction power of all of the existing definitions of BPD. The best definition of BPD must be established through additional research.