Rates of Bronchopulmonary Dysplasia in Very Preterm Neonates in Europe: Results from the MOSAIC CohortGortner L.a · Misselwitz B.b · Milligan D.c · Zeitlin J.d · Kollée L.e · Boerch K.f · Agostino R.g · Van Reempts P.h · Chabernaud J.-L.i · Bréart G.d · Papiernik E.j, † · Jarreau P.-H.k · Carrapato M.l · Gadzinowski J.m · Draper E.n · for the members of the MOSAIC Research Group
aPediatric University Hospital, University of Saarland, Homburg, and bGeschäftsstelle Qualitätssicherung Hessen, Eschborn, Germany; cDepartment of Neonatology, Royal Victoria Infirmary, Newcastle upon Tyne, UK; dINSERM, UMR S149, Epidemiological Research Unit on Perinatal and Women’s Health, Université Pierre et Marie Curie – Paris 6, Paris, France; eRadboud University Nijmegen Medical Center, Nijmegen, The Netherlands; fDepartment of Paediatrics, Hvidovre University Hospital, Hvidovre, Denmark; gDepartment for Mother’s and Infant’s Health, Hospital San Giovanni Calibita - Fatebenefratelli, Rome, Italy; hDepartment of Neonatology, Antwerp University Hospital, University of Antwerp and Study Centre for Perinatal Epidemiology Flanders, Antwerp, Belgium; iService de Réanimation Néonatale, Hôpital Antoine Béclere, Clamart, jUniversité Paris V Réné Descartes et Service de Gynécologie-Obstétrique de Port-Royal, and kUniversité Paris V Réné Descartes et Service de Médecine Néonatale de Port-Royal, Paris, France; lDepartment of Pediatrics, Hospital Sao Sebastiao, Sta Maria de Feira, Portugal; mDepartment of Neonatology, University of Medical Sciences, Poznan, Poland; nNeonatal Unit, Department of Health Sciences, Leicester Royal Infirmary, University of Leicester, Leicester, UK
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Background: A considerable local variability in the rate of bronchopulmonary dysplasia (BPD) has been recorded previously. Objectives: The objectives of the present study were to describe regional differences in the rate of BPD in very preterm neonates from a European population-based cohort and to further delineate risk factors. Methods: 4,185 survivors to 36 weeks’ postmenstrual age of 4,984 live-born infants born at 24+0–31+6 weeks’ gestation in 2003 (the MOSAIC cohort) in 10 European regions were enrolled using predefined structured questionnaires. Results: Overall median gestational age of preterms without BPD was 30 weeks (range 23–31), median birth weight 1,320 g (range 490–3,150) compared with 27 weeks (23–31) and 900 g (370–2,460) in those with BPD. The region-specific crude rate of BPD ranged from 10.2% (Italian region) to 24.8% (UK Northern region). Maternal hypertension, immaturity, male gender, small for gestational age, Apgar <7 and region of care were associated with an increased incidence of BPD on multivariate analysis. Conclusion: A wide variability of BPD between European regions may be explained by different local practices; the strongest association however was with degree of immaturity.
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