Respiratory support and bronchopulmonary dysplasia in infants born at 22–26 weeks gestation in Sweden, 2004–2007 and 2014–2016
(2025) In European Respiratory Journal 65(1).- Abstract
Background Our aim was to evaluate if increased survival and new ventilation strategies were accompanied by a changed incidence of bronchopulmonary dysplasia (BPD) in Sweden over a decade. Methods Data from two Swedish population-based studies of live-born infants with gestational age (GA) 22–26 weeks, born during 2004–2007 (n=702) and 2014–2016 (n=885), were compared for survival, any BPD, moderate BPD and severe BPD and the composite outcomes of any BPD or death and severe BPD or death at 36 weeks postmenstrual age (PMA). Ventilation strategies and interventions were analysed. Any BPD was defined as the use of supplemental oxygen or any respiratory support at 36 weeks PMA, moderate BPD as nasal cannula with <30% oxygen and severe... (More)
Background Our aim was to evaluate if increased survival and new ventilation strategies were accompanied by a changed incidence of bronchopulmonary dysplasia (BPD) in Sweden over a decade. Methods Data from two Swedish population-based studies of live-born infants with gestational age (GA) 22–26 weeks, born during 2004–2007 (n=702) and 2014–2016 (n=885), were compared for survival, any BPD, moderate BPD and severe BPD and the composite outcomes of any BPD or death and severe BPD or death at 36 weeks postmenstrual age (PMA). Ventilation strategies and interventions were analysed. Any BPD was defined as the use of supplemental oxygen or any respiratory support at 36 weeks PMA, moderate BPD as nasal cannula with <30% oxygen and severe BPD as ≽30% oxygen, continuous positive airway pressure (CPAP) or mechanical ventilation. Results Survival to 36 weeks PMA increased from 72% to 81% (p<0.001). Total days on mechanical ventilation increased from a median of 9 to 16 days (p<0.001). High-flow nasal cannula (HFNC) was introduced between the cohorts, and days of CPAP and HFNC increased from 44 to 50 days (p<0.001). Any BPD was unchanged at 65% versus 68%. Moderate BPD increased from 37% to 47% (p=0.003), while the incidence of severe BPD decreased from 28% to 23% (p<0.046). Severe BPD or death decreased from 48% to 37% (p<0.001), while any BPD or death remained unchanged at 74% versus 75%. Conclusion Even though an increased survival of infants born at 22–26 weeks GA was accompanied by an increased duration of invasive and non-invasive respiratory support, the incidence of any BPD remained unchanged, while severe BPD decreased in infants alive at 36 weeks PMA.
(Less)
- author
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Respiratory Journal
- volume
- 65
- issue
- 1
- article number
- 2401203
- publisher
- European Respiratory Society
- external identifiers
-
- scopus:85216036390
- pmid:39510555
- ISSN
- 0903-1936
- DOI
- 10.1183/13993003.01203-2024
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: Copyright ©The authors 2025.
- id
- 904dc2b0-7557-403b-8b37-f58c20e73c22
- date added to LUP
- 2025-04-11 09:51:07
- date last changed
- 2025-07-04 16:49:56
@article{904dc2b0-7557-403b-8b37-f58c20e73c22,
abstract = {{<p>Background Our aim was to evaluate if increased survival and new ventilation strategies were accompanied by a changed incidence of bronchopulmonary dysplasia (BPD) in Sweden over a decade. Methods Data from two Swedish population-based studies of live-born infants with gestational age (GA) 22–26 weeks, born during 2004–2007 (n=702) and 2014–2016 (n=885), were compared for survival, any BPD, moderate BPD and severe BPD and the composite outcomes of any BPD or death and severe BPD or death at 36 weeks postmenstrual age (PMA). Ventilation strategies and interventions were analysed. Any BPD was defined as the use of supplemental oxygen or any respiratory support at 36 weeks PMA, moderate BPD as nasal cannula with <30% oxygen and severe BPD as ≽30% oxygen, continuous positive airway pressure (CPAP) or mechanical ventilation. Results Survival to 36 weeks PMA increased from 72% to 81% (p<0.001). Total days on mechanical ventilation increased from a median of 9 to 16 days (p<0.001). High-flow nasal cannula (HFNC) was introduced between the cohorts, and days of CPAP and HFNC increased from 44 to 50 days (p<0.001). Any BPD was unchanged at 65% versus 68%. Moderate BPD increased from 37% to 47% (p=0.003), while the incidence of severe BPD decreased from 28% to 23% (p<0.046). Severe BPD or death decreased from 48% to 37% (p<0.001), while any BPD or death remained unchanged at 74% versus 75%. Conclusion Even though an increased survival of infants born at 22–26 weeks GA was accompanied by an increased duration of invasive and non-invasive respiratory support, the incidence of any BPD remained unchanged, while severe BPD decreased in infants alive at 36 weeks PMA.</p>}},
author = {{Löfberg, Linn and Abrahamsson, Thomas and Björklund, Lars J. and Westas, Lena Hellström and Farooqi, Aijaz and Domellöf, Magnus and Ådén, Ulrika and Gadsbøll, Christian and Källén, Karin and Ley, David and Normann, Erik and Sävman, Karin and Elfvin, Anders and Håkansson, Stellan and Norman, Mikael and Sindelar, Richard and Serenius, Fredrik and Um-Bergström, Petra}},
issn = {{0903-1936}},
language = {{eng}},
number = {{1}},
publisher = {{European Respiratory Society}},
series = {{European Respiratory Journal}},
title = {{Respiratory support and bronchopulmonary dysplasia in infants born at 22–26 weeks gestation in Sweden, 2004–2007 and 2014–2016}},
url = {{http://dx.doi.org/10.1183/13993003.01203-2024}},
doi = {{10.1183/13993003.01203-2024}},
volume = {{65}},
year = {{2025}},
}