256 - Global Prevalence of Bronchopulmonary Dysplasia in Very Low Birth Weight or Very Low Gestational Age Neonates: A Systematic Review and Meta-Analysis

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 256
Publication Number: 256.34

Alvaro Moreira, University of Texas Health Science Center San Antonio, San Antonio, TX, United States; Michelle Noronha, The University of Texas Health Science Center at San Antonio Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, United States; Aliha H. Naqvi, University of Texas at Austin, San Antonio, TX, United States; Jooby Joy, University of Texas Rio Grande Valley School of Medicine, San Antonio, TX, United States; Maxwell D. Jones, Dartmouth College, Austin, TX, United States; Aina M. Tarriela, University of Texas at San Antonio, United States; Charles T. Valadie, The University of Texas Health Science Center at San Antonio Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, United States; Sarah Zoretic, University of Texas Southwestern, Dallas, TX, United States

Presenting Author(s)

Alvaro Moreira, MD, MSc

Associate Professor
The University of Texas Health Science Center at San Antonio Joe R. and Teresa Lozano Long School of Medicine
San Antonio, Texas, United States

Background:

Large-scale estimates of bronchopulmonary dysplasia (BPD) constitute the basis for adequate prevention and treatment. However, systematic approaches to ascertain global rates of BPD are lacking.

Objective:

To conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤1,500 grams) or very low gestational age ( < 32 weeks) neonates.

Design/Methods:

Data sources: A search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed.

Study selection: Randomized controlled trials and observational studies evaluating rates of BPD in very low birthweight or very low gestational age neonates were eligible. Included studies defined BPD as positive pressure ventilation or oxygen requirement at 28 days (BPD28) or at 36 weeks postmenstrual age (BPD36).

Data extraction and synthesis: Two reviewers independently conducted all stages of the review. Random-effects meta-analysis was used to calculate the pooled prevalence. Subgroup analyses included gestational age group, birthweight category, study period, continent, setting, and gross domestic product. Meta-regression was performed to identify the impact of significant variables on study effect.
Main outcomes and measures: Prevalence of BPD defined as BPD28, BPD36, any BPD (BPD28 or BPD36), and by subgroups.

Results:

Eighty-seven studies with a cumulative 723,269 patients were included in this review. The pooled prevalence was 23% [95% CI, 17%-30%] for BPD28 (n=29 studies, 101,848 neonates), 21% [95% CI, 17%-24%] for BPD36 (n=56 studies, 584,448 neonates), and 19% [95% CI, 16%-22%] for any BPD (n=70 studies, 607,653 neonates). Refer to Figures 1 and 2. In subgroup meta-analyses, birthweight and gestational age were strong drivers of the pooled prevalence of BPD. For instance, pooled rates of BPD36 according to birthweight were as follows: 501-750 grams, 45% [95% CI, 28%-64%]; 751-1000 grams, 32% [95% CI, 28%-36%]; 1001-1250 grams, 16% [95% CI, 14%-18%]; 1251-1500 grams, 8% [95% CI, 7%-9%]; ≤1000 grams, 38% [95% CI, 30%-47%], ≤1500 grams, 19% [95% CI, 15%-23%]. No differences were observed in BPD36 rates across time (1990-1999 vs. 2000-2009 vs. 2010-2019) and rates were higher in Oceania compared to other continents.

Conclusion(s):

This study provides a global estimation of BPD prevalence in very low birth weight/very low gestation neonates.
BPD1.jpeg

BPD2.jpeg