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Characteristics associated with death or tracheostomy in infants with bronchopulmonary dysplasia following predominant non-invasive respiratory support

Journal of Perinatology volume 46, pages 167–174 (2026)Cite this article

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Abstract

Objective

Identify characteristics associated with death or tracheostomy (D/T) in preterm infants with bronchopulmonary dysplasia (BPD) predominantly managed with non-invasive respiratory support prior to 36 weeks postmenstrual age (PMA).

Study design

Retrospective cohort study at Children’s Hospital of Philadelphia of 134 infants meeting inclusion criteria between 2010 and 2017. Various clinical characteristics were considered as predictor variables of the primary outcome, D/T; those associated at p < 0.10 in bivariable logistic regression were evaluated in multivariable models.

Results

Twenty-one (16%) infants had D/T. Treatment with pulmonary vasodilators and the presence of pulmonary hypertension (PH) on echocardiogram at 36 weeks PMA were associated with D/T in bivariable analyses. Pulmonary vasodilator use remained statistically significant in adjusted multivariable models.

Conclusions

We identified a strong association between PH and D/T in this cohort. Our findings emphasize the importance of specialized BPD management that includes early identification of PH in this high-risk population.

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Fig. 1: Study cohort identification flow diagram.

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Author information

Authors and Affiliations

  1. Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Heidi Morris, Megan Reilly, Huayan Zhang, Kathleen Gibbs, Sara B. DeMauro & Nicolas A. Bamat

  2. Newborn and Infant Chronic Lung Disease Program, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Heidi Morris, Huayan Zhang, Kathleen Gibbs, Sara B. DeMauro & Nicolas A. Bamat

  3. Division of Neonatology and Center for Newborn Care, Guangzhou Women and Children’s Medical Center, Guangzhou, China

    Huayan Zhang & Xiaoyue Dong

  4. University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Huayan Zhang, Kathleen Gibbs, Catherine M. Avitabile, Sara B. DeMauro & Nicolas A. Bamat

  5. Division of Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Catherine M. Avitabile

  6. Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Nicolas A. Bamat

  7. Center for Clinical Pharmacology; Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Nicolas A. Bamat

Authors
  1. Heidi Morris
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  2. Megan Reilly
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  5. Kathleen Gibbs
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  6. Catherine M. Avitabile
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  7. Sara B. DeMauro
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  8. Nicolas A. Bamat
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Contributions

HM collected data and wrote the first draft of the manuscript. MR helped with data management and analysis. HZ had the initial idea for study design. XD helped with data collection. KG, CMA, and SBDeM helped with manuscript writing. NAB was responsible for data analysis and helped write the manuscript.

Corresponding author

Correspondence to Heidi Morris.

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Competing interests

The authors declare no competing interests.

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Supplementary information

41372_2025_2234_MOESM1_ESM.docx (download DOCX )

SA1. Unadjusted and adjusted association between cohort characteristics and primary outcome of death or tracheostomy, sensitivity analysis

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Morris, H., Reilly, M., Zhang, H. et al. Characteristics associated with death or tracheostomy in infants with bronchopulmonary dysplasia following predominant non-invasive respiratory support. J Perinatol 46, 167–174 (2026). https://doi.org/10.1038/s41372-025-02234-z

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