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A comparison of newer classifications of bronchopulmonary dysplasia: findings from the Children’s Hospitals Neonatal Consortium Severe BPD Group

Journal of Perinatology volume 42, pages 58–64 (2022)Cite this article

Subjects

Abstract

Objective

To compare three bronchopulmonary dysplasia (BPD) definitions against hospital outcomes in a referral-based population.

Study design

Data from the Children’s Hospitals Neonatal Consortium were classified by 2018 NICHD, 2019 NRN, and Canadian Neonatal Network (CNN) BPD definitions. Multivariable models evaluated the associations between BPD severity and death, tracheostomy, or length of stay, relative to No BPD references.

Results

Mortality was highest in 2019 NRN Grade 3 infants (aOR 225), followed by 2018 NICHD Grade 3 (aOR 145). Infants with lower BPD grades rarely died (<1%), but Grade 2 infants had aOR 7–21-fold higher for death and 23–56-fold higher for tracheostomy.

Conclusions

Definitions with 3 BPD grades had better discrimination and Grade 3 2019 NRN had the strongest association with outcomes. No/Grade 1 infants rarely had severe outcomes, but Grade 2 infants were at risk. These data may be useful for counseling families and determining therapies for infants with BPD.

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Fig. 1: Flow diagram for patient selection.
Fig. 2: Distribution of respiratory support and FiO2 among infants on support at 36 weeks’ PMA.

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Funding

The Children’s Hospitals Neonatal Consortium (501-c3 organization) supported the statistical analyses presented in this manuscript.

Author information

Authors and Affiliations

  1. Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Shilpa Vyas-Read

  2. The Ohio State University and Nationwide Children’s Hospital, Columbus, OH, USA

    J. Wells Logan & Leif D. Nelin

  3. University of Missouri-Kansas City and Children’s Mercy Hospital, Kansas, MO, USA

    Alain C. Cuna & William Truog

  4. Johns Hopkins University and Johns Hopkins All Children’s Hospital, Baltimore, MD, USA

    Joana Machry

  5. Harvard University and Boston Children’s Hospital, Cambridge, MA, USA

    Kristin T. Leeman

  6. Indiana University and Riley Children’s Hospital, Bloomington, IN, USA

    Rebecca S. Rose & William A. Engle

  7. University of California, Irvine and Children’s Hospital of Orange County, Los Angeles, CA, USA

    Michel Mikhael

  8. University of Colorado and Children’s Hospital Colorado, Boulder, CO, USA

    Erica Wymore

  9. University of Pittsburgh and Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    John W. Ibrahim

  10. University of Washington, Seattle and Seattle Children’s Hospital, Seattle, WA, USA

    Robert J. DiGeronimo

  11. University of Texas, Southwestern and Children’s Medical Center of Dallas, Dallas, TX, USA

    Sushmita Yallapragada & Rashmin C. Savani

  12. University of Cincinnati and Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Beth E. Haberman

  13. University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Michael A. Padula

  14. Northwestern University and Ann & Robert H Lurie Children’s Hospital, Evanston, IL, USA

    Nicolas F. Porta & Karna Murthy

  15. University of Alabama, Birmingham and Children’s of Alabama, Birmingham, AL, USA

    Carl H. Coghill

  16. Children’s Hospital Association, Lenexa, KS, USA

    Isabella Zaniletti

  17. Medical College of Wisconsin and Children’s Wisconsin, Milwaukee, WI, USA

    Joanne M. Lagatta

Authors
  1. Shilpa Vyas-Read
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  2. J. Wells Logan
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  3. Alain C. Cuna
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  4. Joana Machry
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  5. Kristin T. Leeman
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  6. Rebecca S. Rose
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  7. Michel Mikhael
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  8. Erica Wymore
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  9. John W. Ibrahim
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  10. Robert J. DiGeronimo
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  11. Sushmita Yallapragada
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  12. Beth E. Haberman
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  13. Michael A. Padula
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  14. Nicolas F. Porta
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  15. Karna Murthy
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  16. Leif D. Nelin
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  17. Carl H. Coghill
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  18. Isabella Zaniletti
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  19. Rashmin C. Savani
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  20. William Truog
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  21. William A. Engle
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  22. Joanne M. Lagatta
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Contributions

Author contributions to this manuscript are as follows: study design, data analysis, and preparation of the manuscript (SVR, JML); data analysis and manuscript review (JWL, ACC, JM, KTL, RSR, MM, EW, JWI, RJD, SY, BEH, MAP, NFP, KM, LDN, CHC, RCS, WET, and WAE); Statistical analyses and manuscript review (IZ).

Corresponding author

Correspondence to Shilpa Vyas-Read.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

De-identified data analyses were approved by the Institutional Review Board of Stanley Manne Research Institute affiliated with the Ann and Robert H. Lurie Children’s Hospital of Chicago. All participating centers obtained regulatory oversight to participate in the CHNC.

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Vyas-Read, S., Logan, J.W., Cuna, A.C. et al. A comparison of newer classifications of bronchopulmonary dysplasia: findings from the Children’s Hospitals Neonatal Consortium Severe BPD Group. J Perinatol 42, 58–64 (2022). https://doi.org/10.1038/s41372-021-01178-4

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