Prediction of bronchopulmonary dysplasia during first day of life in preterm infants

We retrospectively studied 79 preterm infants with respiratory distress syndrome treated with synthetic surfactant during the first day of life in order to determine the prediction value of clinical variables and the response in surfactant treatment for later development of bronchopulmonary dysplasia in those infants. The infants were divided into three groups according to the clinical course of disease. The response in surfactant treatment was defined as the reduction in oxygen index. The overall incidence of bronchopulmonary dysplasia was 24%. A lower birth weight and gestational age were observed among the infants who developed bronchopulmonary dysplasia (p = 0.001). Infants who failed to show a reduction in the oxygen index at 6 hours after surfactant replacement therapy were at high risk of later development of bronchopulmonary dysplasia or death (p = 0.01). There was no difference between the bronchopulmonary dysplasia and non-bronchopulmonary dysplasia in Apgar score, sex, fetal distress, mode of delivery and first pH. The 1-minute Apgar score was lower (p = 0.001) and more fetal distress (p = 0.01) were noted in the infants who later died. Failure to reduce the oxygen index after surfactant treatment may provide early identification of infants who will develop bronchopulmonary dysplasia or death.