Het beloop van bronchopulmonale dysplasie bij prematuren in de eerste twee levensjaren.

Teerink, N. (2014) Het beloop van bronchopulmonale dysplasie bij prematuren in de eerste twee levensjaren. thesis, Medicine.

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Abstract

Introduction. Premature children <32 weeks often develop Respiratory Distress Syndrome (RDS). As a result of increased knowledge of the pathophysiology and the usage of various respiratory modalities in combination with the administration of exogenous surfactant, more extremely preterm born babies with RDS survive. If the children still need extra oxygen on the 28th day postpartum in combination with abnormalities on the chest x-ray it is called bronchopulmonary dysplasia (BPD). The current definition for BPD is: O2-dependency on the post menstrual age of 36 weeks, combined with specific derogations seen on the chest X-ray. BPD is subdivided into mild, moderate and severe BPD. In mild BPD there is no oxygen dependency at the age of 36 weeks, in moderate BPD the oxygen dependency is not more than 30% and in severe BPD the oxygen dependency level is higher than 30%. In the University Medical Center Groningen (UMCG) premature children are mainly admitted from the 3 northern provinces of the Netherlands. After their stay at the neonatal intensive care unit (NICU) they are transferred to local hospitals. However, there is very little information about the prevalence, the risk factors and the development of these children diagnosed with BPD. Objective. The aim of this study is to get more information about the prevalence and the development of BPD in premature children <32 weeks who were treated at the NICU in the UMCG. Secondly we wanted to investigate if there are perinatal and neonatal risk factors that influence the severity of BPD. Methods. Retrospective study. The prevalence of moderate and severe BPD in children who have been admitted to the UMCG between 2005 and 2012 and who are transferred to the Martini Hospital (MZH) or the Medical Center Leeuwarden (MCL) has been calculated. An extensive literature review has been conducted to establish a focus on a number of risk factors and outcome measures in the development of BPD. Furthermore we examined whether these risk factors influenced the severity of BPD at the children in our cohort by using logistic regression analyses. Finally, there have been looked at whether the severity of BPD affected the outcome measures. For this the Mann-Whitney U test and the Chi-square test have been used. Results. In the period 2005-2012 a total of 640 children were transferred to the MZH or the MCL, 15 children were diagnosed with moderate BPD (1.3%) and 51 children were diagnosed with severe BPD (4.2%). Children with moderate and severe BPD were born after a shorter gestational age than children with mild or no BPD. The birth weight of these children was also lower. Between the group of moderate and severe BPD no significant differences were found for these variables. No significant differences between moderate and severe BPD were found for the following risk factors: gender, corticosteroids, diuretics, necrotic enterocolitis, persistent ductus arteriosus, birth length, number of blood transfusions and number of infections (OR’s between 1.3 and 2.5). Having moderate or severe BPD did not show any significant differences in the outcome measures, growth, time spent in hospital, rehospitalization in the first year of life, hearing defects, developmental problems, eye diseases and inguinal hernia. Conclusion. In our study sample moderate and severe BPD was diagnosed in 5.5% of the cases, 1.3% of which was diagnosed with moderate BPD and 4.2% with severe BPD. No risk factors were found that significantly influenced the severity of BPD. The severity of BPD was not associated with any of the examined outcome measures.

Item Type:	Thesis (Thesis)
Supervisor name:	Bos, Prof. dr. A.F.
Supervisor name:	Geven, Dr. W.B. and Martiniziekenhuis and Vries-Olsder, Dr. N.K.S. de and Medisch Centrum Leeuwarden
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:57
Last Modified:	25 Jun 2020 10:57
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1780

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