Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants
Matthew M Laughon, John C Langer, Carl L Bose, P Brian Smith, Namasivayam Ambalavanan, Kathleen A Kennedy, Barbara J Stoll, Susie Buchter, Abbot R Laptook, Richard A Ehrenkranz, C Michael Cotten, Deanne E Wilson-Costello, Seetha Shankaran, Krisa P Van Meurs, Alexis S Davis, Marie G Gantz, Neil N Finer, Bradley A Yoder, Roger G Faix, Waldemar A Carlo, Kurt R Schibler, Nancy S Newman, Wade Rich, Abhik Das, Rosemary D Higgins, Michele C Walsh, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Dan Gingras, Susan Barnett, Sarah Lillie, Kim Francis, Dawn Andrews, Kristen Angela, Avroy A Fanaroff, Bonnie S Siner, Duncan Neuhauser, Leslie Clarke, Edward F Donovan, Vivek Narendran, Kate Bridges, Barbara Alexander, Cathy Grisby, Marcia Worley Mersmann, Holly L Mincey, Jody Hessling, Ronald N Goldberg, Kathy J Auten, Kimberly A Fisher, Katherine A Foy, Gloria Siaw, Anthony Piazza, David P Carlton, Ellen C Hale, Marcia Berry Bishop, Irma Seabrook, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, William A Engle, Faithe Hamer, Dianne E Herron, Richard Hooper, Lucy C Miller, Leslie D Wilson, Mary Anne Berberich, Carol J Blaisdell, Dorothy B Gail, James P Kiley, W Kenneth Poole, Margaret Cunningham, Betty K Hastings, Amanda R Irene, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, Jeanette O'Donnell Auman, James W Pickett, Scott E Schaefer, Dennis Wallace, Qing Yao, Kristin M Zaterka-Baxter, David K Stevenson, M Bethany Ball, Melinda S Proud, William D Rhine, Carol Kibler, Jeffrey R Parker, Ivan D Frantz 3rd, John M Fiascone, Anne Furey, Brenda L MacKinnon, Ellen Nylen, Monica V Collins, Shirley S Cosby, Vivien A Phillips, William Rhine, Maynard R Rasmussen, Paul R Wozniak, Wade Rich, Gregory Heldt, Mindy Grabarczyk, Christina Joseph, Kathy Arnell, Renee Bridge, Clarence Demetrio, Jim Goodmar, Chris Henderson, Edward F Bell, John A Widness, Jonathan M Klein, Karen J Johnson, Nancy J Krutzfield, Shahnaz Duara, Charles R Bauer, Ruth Everett-Thomas, Amy Mur Worth, Kristi L Watterberg, Robin K Ohls, Julie Rohr, Conra Backstrom Lacy, Nirupama Laroia, Dale L Phelps, Robert A Sinkin, Linda J Reubens, Mary Rowan, Erica Burnell, Jon E Tyson, Brenda H Morris, Beverly Foley Harris, Anna E Lis, Sarah Martin, Georgia E McDavid, Sharon L Wright, Esther G Akpa, Patty A Cluff, Claudia I Franco, Patti L Pierce Tate, Pablo J Sánchez, Walid A Salhab, Charles R Rosenfeld, Luc P Brion, James Allen, Alicia Guzman, Gaynelle Hensley, Melissa H Leps, Susie Madison, Melissa Martin, Nancy A Miller, Araceli Solis, Diana M Vasil, Kerry Wilder, Jill Burnett, Jennifer J Jensen, Karen A Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, T Michael O'Shea, Nancy J Peters, Beena G Sood, S Nadya J Kazzi, Rebecca Bara, Maria Batts, Elizabeth Billian, Kimberly Hayes-Hart, Mary Johnson, Geraldine Muran, Vineet Bhandari, Harris C Jacobs, Pat Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft, Matthew M Laughon, John C Langer, Carl L Bose, P Brian Smith, Namasivayam Ambalavanan, Kathleen A Kennedy, Barbara J Stoll, Susie Buchter, Abbot R Laptook, Richard A Ehrenkranz, C Michael Cotten, Deanne E Wilson-Costello, Seetha Shankaran, Krisa P Van Meurs, Alexis S Davis, Marie G Gantz, Neil N Finer, Bradley A Yoder, Roger G Faix, Waldemar A Carlo, Kurt R Schibler, Nancy S Newman, Wade Rich, Abhik Das, Rosemary D Higgins, Michele C Walsh, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Dan Gingras, Susan Barnett, Sarah Lillie, Kim Francis, Dawn Andrews, Kristen Angela, Avroy A Fanaroff, Bonnie S Siner, Duncan Neuhauser, Leslie Clarke, Edward F Donovan, Vivek Narendran, Kate Bridges, Barbara Alexander, Cathy Grisby, Marcia Worley Mersmann, Holly L Mincey, Jody Hessling, Ronald N Goldberg, Kathy J Auten, Kimberly A Fisher, Katherine A Foy, Gloria Siaw, Anthony Piazza, David P Carlton, Ellen C Hale, Marcia Berry Bishop, Irma Seabrook, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, William A Engle, Faithe Hamer, Dianne E Herron, Richard Hooper, Lucy C Miller, Leslie D Wilson, Mary Anne Berberich, Carol J Blaisdell, Dorothy B Gail, James P Kiley, W Kenneth Poole, Margaret Cunningham, Betty K Hastings, Amanda R Irene, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, Jeanette O'Donnell Auman, James W Pickett, Scott E Schaefer, Dennis Wallace, Qing Yao, Kristin M Zaterka-Baxter, David K Stevenson, M Bethany Ball, Melinda S Proud, William D Rhine, Carol Kibler, Jeffrey R Parker, Ivan D Frantz 3rd, John M Fiascone, Anne Furey, Brenda L MacKinnon, Ellen Nylen, Monica V Collins, Shirley S Cosby, Vivien A Phillips, William Rhine, Maynard R Rasmussen, Paul R Wozniak, Wade Rich, Gregory Heldt, Mindy Grabarczyk, Christina Joseph, Kathy Arnell, Renee Bridge, Clarence Demetrio, Jim Goodmar, Chris Henderson, Edward F Bell, John A Widness, Jonathan M Klein, Karen J Johnson, Nancy J Krutzfield, Shahnaz Duara, Charles R Bauer, Ruth Everett-Thomas, Amy Mur Worth, Kristi L Watterberg, Robin K Ohls, Julie Rohr, Conra Backstrom Lacy, Nirupama Laroia, Dale L Phelps, Robert A Sinkin, Linda J Reubens, Mary Rowan, Erica Burnell, Jon E Tyson, Brenda H Morris, Beverly Foley Harris, Anna E Lis, Sarah Martin, Georgia E McDavid, Sharon L Wright, Esther G Akpa, Patty A Cluff, Claudia I Franco, Patti L Pierce Tate, Pablo J Sánchez, Walid A Salhab, Charles R Rosenfeld, Luc P Brion, James Allen, Alicia Guzman, Gaynelle Hensley, Melissa H Leps, Susie Madison, Melissa Martin, Nancy A Miller, Araceli Solis, Diana M Vasil, Kerry Wilder, Jill Burnett, Jennifer J Jensen, Karen A Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, T Michael O'Shea, Nancy J Peters, Beena G Sood, S Nadya J Kazzi, Rebecca Bara, Maria Batts, Elizabeth Billian, Kimberly Hayes-Hart, Mary Johnson, Geraldine Muran, Vineet Bhandari, Harris C Jacobs, Pat Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft
Abstract
Rationale: Benefits of identifying risk factors for bronchopulmonary dysplasia in extremely premature infants include providing prognostic information, identifying infants likely to benefit from preventive strategies, and stratifying infants for clinical trial enrollment.
Objectives: To identify risk factors for bronchopulmonary dysplasia, and the competing outcome of death, by postnatal day; to identify which risk factors improve prediction; and to develop a Web-based estimator using readily available clinical information to predict risk of bronchopulmonary dysplasia or death.
Methods: We assessed infants of 23-30 weeks' gestation born in 17 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and enrolled in the Neonatal Research Network Benchmarking Trial from 2000-2004.
Measurements and main results: Bronchopulmonary dysplasia was defined as a categorical variable (none, mild, moderate, or severe). We developed and validated models for bronchopulmonary dysplasia risk at six postnatal ages using gestational age, birth weight, race and ethnicity, sex, respiratory support, and Fi(O(2)), and examined the models using a C statistic (area under the curve). A total of 3,636 infants were eligible for this study. Prediction improved with advancing postnatal age, increasing from a C statistic of 0.793 on Day 1 to a maximum of 0.854 on Day 28. On Postnatal Days 1 and 3, gestational age best improved outcome prediction; on Postnatal Days 7, 14, 21, and 28, type of respiratory support did so. A Web-based model providing predicted estimates for bronchopulmonary dysplasia by postnatal day is available at https://neonatal.rti.org.
Conclusions: The probability of bronchopulmonary dysplasia in extremely premature infants can be determined accurately using a limited amount of readily available clinical information.
Source: PubMed