Bronchopulmonary Dysplasia in Preterm Neonates in a Level III Neonatal Unit in India

Objective: To find out the incidence and associations of bronchopulmonary dysplasia (BPD) in preterm neonates. Design: Descriptive cohort. Methods: All consecutively born neonates <33 weeks gestation requiring oxygen or respiratory support during first 3 days of life were enrolled from a level III neonatal unit in Chandigarh, India. Those with malformations were excluded. Placenta was examined for histological chorioamnionitis in preterm rupture of membranes and/or preterm spontaneous onset of labour. Serum Malondialdehyde (MDA) and Superoxide dismutase (SOD) and Catalase levels were estimated on day 3 of life. All recruited neonates were followed up till discharge or death. Results: Out of 250 neonates enrolled, 170 (68%) survived till day 28 and BPD developed in 19 (11.2%) infants. The mean gestation and birth weight were significantly lower in infants who developed BPD. Chorioamnionitis (clinical 5.3% vs 1.9%, P=0.375; and histological 37.5% vs 16.7%, P<0.001), patent ductus arteriosus (PDA) (52.6% vs 8.9%, P<0.001), median (IQR) sepsis episodes [2 (2,3) vs 1 (1,2), P<0.001], invasive ventilation (84.2% vs 11.3%, P<0.001), and duration of ventilation [56 (4) d vs 4 (5) d, P=0.001] were significantly higher in infants with BPD. Serum MDA, SOD and Catalase levels were comparable between the two groups. Conclusion: Chorioamnionitis, PDA and sepsis were significantly associated with BPD.