D15-07 Bronchopulmonary Dysplasia Is Associated With Pulmonary and Cardiovascular Outcomes in Adults

Rationale Bronchopulmonary dysplasia (BPD) is associated with increased airflow obstruction and poor cardiometabolic health in young adults, but little is known about pulmonary and cardiovascular sequelae in later adulthood. We sought to evaluate outcomes in older adults comparing BPD to low birth weight (LBW) or preterm births without BPD. Methods We developed an electronic health record-based cohort of adults with diagnosis codes for BPD, prematurity, or LBW between July 2016 - October 2025 from the Johns Hopkins Healthcare System. Individuals were categorized into BPD versus prematurity/LBW without BPD. Age was dichotomized as 18-40 or > 40 years to compare younger and older adults. Demographics, smoking exposure, presence of pulmonary function testing (PFT) or echocardiography, presence of a diagnosis code for asthma, COPD, heart failure, and pulmonary hypertension, proportion of an individual’s hospitalizations that were secondary to respiratory or cardiovascular causes, and PFT z-score distributions were compared across age-stratified BPD categories using t-tests, rank sum testing, or chi-squared tests as appropriate. Results A total of 1,938 adults with premature and/or LBW births were identified with 322(17%) having BPD. Comparing BPD and premature/LBW groups, average ages were 34±1.1 and 33±0.4 years respectively, with roughly 25% in both groups >40 (27% versus 25%, p = 0.4). There were more females in the premature/LBW versus BPD group (65% versus 47%, p < 0.001), and nearly half of both groups were Black. There were no significant differences by BPD group in years under follow-up, body mass index, ever smokers, or median pack-years smoked. Among younger and older adults, the BPD group more commonly had PFTs and echocardiography, more diagnoses of: COPD(younger adults:23% vs 6%, older adults:67% vs 27%), heart failure(younger adults:4% vs 0.7%, older adults:30% vs 8%), and pulmonary hypertension(younger adults:8% vs 1%, older adults:40% vs 6%), and a greater proportion of respiratory(younger adults:17% vs 9%, older adults:14% vs 5%) or cardiovascular hospitalizations(younger adults:5% vs 2%, older adults:11% vs 7%) than the premature/LBW group (p < 0.05 for all comparisons). Younger adults with BPD had a higher prevalence of asthma diagnosis than the premature/LBW group (92 vs 86%, p = 0.02) with no difference among older adults. In those with PFTs (N = 158), the BPD group had poorer lung function than the premature/LBW group in younger and older adults (Figure 1). Conclusion In a real-world cohort of adults with BPD, both younger and older adults had poorer cardiopulmonary outcomes than individuals with a history of preterm or LBW birth without BPD. This abstract is funded by: NHLBI K23 153778