Abstract Rationale bronchopulmonary dysplasia (BPD) is a frequent morbidity associated with prematurity, carrying significant implications for long-term respiratory health. In developing countries—where preterm birth rates are higher—there is a lack of updated descriptions aligned with the latest consensus definitions. This study aimed to determine the incidence, severity, and factors associated with the development of BPD in infants born at ≤ 32 + 0 weeks’ gestational age in a hospital in Medellín, Colombia. Methods we conducted a retrospective cohort study including neonates ≤32 + 0 weeks admitted to the neonatal unit between 2021 and 2023. Infants born elsewhere, transferred before 36 weeks’ corrected age, or with major congenital malformations were excluded. Clinical records were reviewed to collect clinical variables throughout hospitalization. Incidence rates, medians, and percentiles were estimated. Associations were analyzed using Chi-square, Fisher’s exact, and Mann–Whitney U tests. Results a total of 395 records were reviewed, and 338 patients were included. Males accounted for 55.0% of cases, with a median gestational age of 29 + 4 weeks (IQR 28 + 0–31 + 0) and a birthweight percentile of 48.0 (IQR 25.5–66.6). The predominant preterm birth endotype was infection/inflammation (63.9%). Thirty-nine infants (11.5%) died before 36 weeks’ corrected age. Among survivors, 228 (76.3%) developed BPD: 92.1% (n = 210) were classified as grade 1, 1.2% (n = 4) as grade 2, and 4.1% (n = 14) as grade 3; 3.7% (n = 11) met criteria for potentially fatal BPD. Significant factors associated with BPD (p 0.005) included delivery room intubation (RR 1.29, 95% CI 1.1–1.5), reintubation during hospitalization (RR 1.29, 95% CI 1.2–1.4), and longer duration of mechanical ventilation (p 0.001). Additional associations were systemic steroid use to facilitate extubation (RR 1.32, 95% CI 1.2–1.5), inhaled steroid therapy (RR 1.38, 95% CI 1.3–1.5), and diuretic use due to fluid overload (RR 1.46, 95% CI 1.3–1.6). Infectious complications(RR 1.35, 95% CI 1.2–1.5), particularly catheter-related bloodstream infections and ventilator-associated pneumonia, were strongly linked to BPD. Apnea episodes (RR 1.3, 95% CI 1.1–1.5) and lower weight percentiles at 36 weeks or discharge (p = 0.001) were also significant. Conclusions BPD remains a highly prevalent condition in developing settings, with a considerable proportion of severe disease. The associated factors mirror global data; however, this cohort highlights that in developing countries, nosocomial infections and postnatal growth failure remain major challenges that impact the morbidity of infants with BPD. Strengthening infection control strategies and optimizing postnatal nutrition could represent key opportunities to reduce disease burden and improve long-term outcomes. This abstract is funded by: None
Parra et al. (2026) studied this question.