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OBJECTIVE: This study aimed to compare various respiratory therapies for diagnosing bronchopulmonary dysplasia (BPD) at different postmenstrual ages (PMA), and to undertake a retrospective review at the adverse respiratory outcomes at preschool age to identify the optimal predictors. METHODS: This retrospective cohort study was conducted at a tertiary neonatal intensive care unit enrolling preterm very-low-birth-weight (VLBW) infants. Respiratory status was classified based on modes of respiratory therapy required (supplemental oxygen, oxygen, and/or positive-pressure respiratory support oxygen/PRS, and PRS alone) at the prespecified time points. The frequency of preschool-age pulmonary morbidity, defined as either a Z-score lower than -1.64 on any lung function test, or a diagnosis of asthma and/or at least three admissions for respiratory causes, was compared using regression models, assessing the predictive values of these respiratory supports. RESULTS: Of the 70 VLBW neonates born at a mean gestational age of 27.6 weeks, 57.1 % had composite respiratory morbidities at follow-up. Among the respiratory support modes, oxygen use at 36 and 40 weeks', oxygen/PRS at 36 and 40 weeks', and PRS alone at 36 weeks PMA were significantly associated with undesirable outcomes. Oxygen/PRS use at 36 weeks' PMA showed a numerically higher effect estimate for predicting the effect and area under the curve (AUC) (adjusted odds ratio 7.46, P = 0.01; AUC 0.841). CONCLUSIONS: Supplemental oxygen and/or positive-pressure respiratory support are good predictors of respiratory morbidity. Thirty-six weeks' PMA appears to be a clinically relevant time point for predicting future pulmonary outcomes in this cohort.
Tseng et al. (Sat,) studied this question.