Background: In the past few decades, with increasing advances in neonatology, more preterm infants have survived. In developed countries, about 12% - 42% of surviving very low birth weight (VLBW) infants developed bronchopulmonary dysplasia (BPD). This chronic lung disease is a severe health burden for both the family and public health resources, and presents several challenges to clinicians and public health practitioners. In the Guangdong province of China, there is no reliable data and research on BPD. Objective: This study aimed to assess the incidence and the epidemiological profile of BPD, as well as possible risk factors of BPD in a Guangdong provincial transportation network for critically ill neonates. Methods: This was a retrospective cohort study. Data on all VLBW infants (birth weight ≤ 1500g) who were admitted to the neonatal intensive care unit (NICU) of Guangdong Provincial Women and Children’s Hospital (GDWCH) from Jan. 1st 2013 to Dec.31st 2013 were collected from medical records of GDWCH (n=168). The incidence rate of BPD was estimated, and associations with demographic characteristics, maternal characteristics and factors related to clinical practice were described and assessed by univariate analysis and multivariate regression analysis with stepwise (backward) method. At last, a logistic regression model was adopted to predict the potential risk factors for BPD. Results: The incidence rate of BPD in VLBW infants in this transportation network for critically ill infants during the study period was 44.6 cases per 100 person-years [95% confidence interval (CI) 40.8 - 48.4 cases per 100 person-years] based on the National Institute of Child Health and Human Development’s (NICHD) definition of BPD. Overall, infants with gestational age (GA) < 30 weeks were more likely to develop BPD [adjusted odds ratio (OR) 4.64; 95% CI 1.97, 10.89], compared to the infants with GA ≥ 30 weeks. Infants diagnosed with asphyxia (adjusted OR 2.78; 95% CI 1.08, 7.18) and infants who received endotracheal tube (ETT) ventilation ≥ 1 day (adjusted OR 3.90; 95% CI 1.33, 11.39) also had higher risk of BPD. On the other hand, female infants were less likely to develop BPD than male infants (adjusted OR 0.37; 95% CI 0.16, 0.87). Predictors for the development of BPD were infants with GA < 30 weeks, male gender, asphyxia and ETT ventilation ≥ 1 day. Conclusion: The results of this study suggest that the prevention of prematurity may contribute to a decrease in the incidence of BPD. Improvement on strategies of supplemental oxygen and mechanical ventilation could potentially lower risk in preterm infants. Further study could focus on clinical practice as well as administrative implementation on neonatology, in order to improve healthcare services. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M.S.)--University of Alabama at Birmingham, 2007. / Title from PDF title page (viewed Feb. 1, 2010). Includes bibliographical references (p. 19-24).

No description available.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2009. / Härtill 3 uppsatser.

Orientador: Emilio Carlos Elias Baracat / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T19:56:13Z (GMT). No. of bitstreams: 1 Souza_TathianaGhiside_M.pdf: 2695580 bytes, checksum: b0307c601001a0729b775051fc783c4c (MD5) Previous issue date: 2008 / Resumo: Recém-nascidos prematuros correspondem de 7 a 10% de todos os nascimentos, mas concentram aproximadamente 85% de todas as complicações perinatais, com alto risco para o desenvolvimento de lesões pulmonares, principalmente a displasia broncopulmonar (DBP), e do sistema nervoso central. O objetivo deste estudo foi descrever e comparar a avaliação neurológica de recém-nascidos pré-termo (RNPT) com e sem DBP. Recém-nascidos pré-termo com peso de nascimento inferior a 1.500g e idade gestacional menor de 32 semanas foram avaliados com 40 semanas de idade gestacional corrigida, no Centro de Atenção Integral a Saúde da Mulher (CAISM) da UNICAMP. Foi utilizada a Avaliação Neurológica de Dubowitz, composta integralmente por 34 itens, dos quais 29 foram avaliados, divididos em 6 categorias: tônus, padrões de tônus, reflexos, movimentos, sinais anormais e comportamento. O estado de consciência do RN no momento do exame foi graduado utilizando-se os 6 graus definidos por BRAZELTON (1973). No período de janeiro de 2005 a setembro de 2007, vinte e quatro recém-nascidos, 12 com DBP e 12 controles sem a doença foram avaliados. A idade média de nascimento foi de 28 semanas (+- 1,38) no grupo com DBP e 31 semanas (+- 1,44) no grupo controle; peso médio no grupo de estudo de 884g (+- 202g) e no grupo controle de 1.156g (+- 216g). Dezoito dos 29 itens avaliados foram homogêneos entre os grupos (p = 1,00) e a pontuação geral dos dois grupos não apresentou diferença (p = 0,30). Na análise dos dados descritivos, observou-se um percentual maior de anormalidade no grupo com DBP em oito itens. A avaliação neurológica de RNPTs com e sem Displasia Broncopulmonar, pelo método Dubowitz, não apresenta diferença às 40 semanas de idade gestacional corrigida / Abstract: Preterm newborns corresponds to 7 to 10% of all births, but concentrates approximately 85% of all perinatal complications, with high risk of pulmonary injuries development, mainly bronchopulmonary dysplasia (BPD), and in the central nervous system. This study objective describes and compares preterm newborns neurological assessment with and without BPD. Preterm newborns with birth weight less than 1.500g and gestational age less than 32 weeks were evaluated by Dubowitz Method, with 40 weeks corrected gestational age, at Centro de Atenção Integral a Saúde da Mulher (CAISM) - UNICAMP. Dubowitz Neurological Assessment was used, consisting of 34 items, which 29 were evaluated, grouped in 6 categories: tone, tone patterns, reflexes, movements, abnormal signs and behavior. Newborn behavioral state was graded in 6 degrees defined by BRAZELTON (1973). From January 2005 to September 2007, twenty four newborns with average birth age of 28 weeks (+- 1,38) from BPD group and 31 weeks (+- 1,44) from control group were evaluated; Study¿s group mean weight was 884g (+- 202g) and control¿s group was 1.156g (+- 216g). Eighteen from 29 checked items were classified as homogeneous among groups (p = 1.00) and general score on two groups were not significantly different (p = 0.30). When analyzed in descriptive manner, the data showed greater abnormality percentage on the BPD group in eight items. The neurological assessment using Dubowitz Neurological method on preterm newborns with and without BPD does not show differences from 40 weeks corrected gestational age / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Bronchopulmonary dysplasia (BPD) is diagnosed in approximately 40% of extremely preterm infants, those born before 28 weeks’ gestational age, and affects roughly 10,000 to 15,000 infants annually in the United States alone. Current treatment of BPD aims to not only aid in the survival of the infant but to also minimize further lung damage and promote physiologic growth to enhance lung development and repair. As the pathogenesis of the disease is multifactorial, including pre-, peri-, and postnatal factors, treatment and prevention approaches to BPD are diverse and include both medical treatment and ventilation strategies. Late postnatal steroids (> 7 days of life) have been proven to facilitate extubation and reduce the incidence of BPD in preterm infants. However, there is evidence that the use of steroids may contribute to increased rates of neurological impairment, including increased incidence of cerebral palsy. Given these findings, the American Academy of Pediatrics (AAP) guidelines recommend against the routine use of systemic steroids in the prevention of BPD and instead argues its use should be limited to infants who are considered extremely high-risk. The aim of this study is to determine whether the use of postnatal dexamethasone decreases the risk of developing BPD in a subset of high-risk infants, those with a concomitant diagnosis of necrotizing enterocolitis or late onset sepsis. A sample size of 200 extremely preterm infants with either necrotizing enterocolitis (NEC) and/or sepsis will be enrolled in a multi-center double-blinded randomized controlled trial comparing a low-dose dexamethasone taper and saline placebo. Infants will be evaluated for the development of BPD based on respiratory support and supplemental oxygen requirement at 36 weeks’ post-menstrual age (PMA). Infants will also be evaluated for presence of neurodevelopmental outcomes at 18- to 22-months follow-up. The results of this proposed study will build the evidence base for the safety and efficacy of postnatal steroids in the prevention of BPD in a subset of high risk, extremely preterm infants. This will help to establish a more detailed characterization of infants for which the benefits of steroids outweigh the risks. The results will enable clinicians to make more informed decisions regarding the medical care of extremely preterm infants and more accurately counsel parents on the incidence of subsequent BPD development, as well as long-term morbidities.

No description available.

No description available.

by Tai Fai Fok. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (p. 211-215). / Microfiche. Ann Arbor, Mich. UMI, 1998. 3 microfiches ; 11 x 15 cm.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 163-189).