Prenatal and postnatal risk factors for developing bronchopulmonary dysplasia

Aim. To determine prenatal and postnatal risk factors for developing bronchopulmonary dysplasia in infants < 30 weeks of gestational age. Methods. Over a 22-month period, 115 newborns were enrolled in the study. Details including gestational age, sex, birth weight, prenatal steroids, surfactant treatment, ventilatory support, days of postnatal oxygen requirement, late onset sepsis/ pneumonia, air leaks, patency of ductus arteriosus, and fluid intake were collected. The presence of chorioamnionitis was diagnosed by histological examination. Commercial ELISA kits were used for the determination of the IL-6 and IL-8 levels. Results. Twenty-five infants developed BPD and 90 were enrolled in the non BPD group. Lower gestational age and male sex increased the risk for BPD. There was no difference in the presence of chorioamnitis and the level of IL-6 and IL-8 measured in cord blood and gastric aspirate between the groups. Intubation in the delivery room (resuscitation), need for surfactant treatment, mechanical ventilation, late onset sepsis/pneumonia, increased oxygenation index increased the risk for BPD after adjustment for GA and gender. Conclusion. In our cohort of infants with GA < 30 weeks exposure to prenatal inflammation did not increase the risk for BPD. However, low gestational age, male sex, need for resuscitation, mechanical ventilation and late onset sepsis were major risk factors for BPD development.