title: Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants.
abstract: BACKGROUND
  Benefits of identifying risk factors for bronchopulmonary dysplasia in extremely premature infants include providing prognostic information, identifying infants likely to benefit from preventive strategies, and stratifying infants for clinical trial enrollment.
  
  
  OBJECTIVE
  To identify risk factors for bronchopulmonary dysplasia, and the competing outcome of death, by postnatal day; to identify which risk factors improve prediction; and to develop a Web-based estimator using readily available clinical information to predict risk of bronchopulmonary dysplasia or death.
  
  
  METHODS
  We assessed infants of 23-30 weeks' gestation born in 17 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and enrolled in the Neonatal Research Network Benchmarking Trial from 2000-2004.
  
  
  RESULTS
  Bronchopulmonary dysplasia was defined as a categorical variable (none, mild, moderate, or severe). We developed and validated models for bronchopulmonary dysplasia risk at six postnatal ages using gestational age, birth weight, race and ethnicity, sex, respiratory support, and Fi(O(2)), and examined the models using a C statistic (area under the curve). A total of 3,636 infants were eligible for this study. Prediction improved with advancing postnatal age, increasing from a C statistic of 0.793 on Day 1 to a maximum of 0.854 on Day 28. On Postnatal Days 1 and 3, gestational age best improved outcome prediction; on Postnatal Days 7, 14, 21, and 28, type of respiratory support did so. A Web-based model providing predicted estimates for bronchopulmonary dysplasia by postnatal day is available at https://neonatal.rti.org.
  
  
  CONCLUSIONS
  The probability of bronchopulmonary dysplasia in extremely premature infants can be determined accurately using a limited amount of readily available clinical information.
authors.affiliation: Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina 27599-7596, USA. matt_laughon@med.unc.edu
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Laughon
authors.forename: John C
authors.initials: JC
authors.lastname: Langer
authors.forename: Carl L
authors.initials: CL
authors.lastname: Bose
authors.forename: P Brian
authors.initials: PB
authors.lastname: Smith
authors.forename: Namasivayam
authors.initials: N
authors.lastname: Ambalavanan
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Kennedy
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.forename: Susie
authors.initials: S
authors.lastname: Buchter
authors.forename: Abbot R
authors.initials: AR
authors.lastname: Laptook
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.forename: C Michael
authors.initials: CM
authors.lastname: Cotten
authors.forename: Deanne E
authors.initials: DE
authors.lastname: Wilson-Costello
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
authors.forename: Alexis S
authors.initials: AS
authors.lastname: Davis
authors.forename: Marie G
authors.initials: MG
authors.lastname: Gantz
authors.forename: Neil N
authors.initials: NN
authors.lastname: Finer
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Yoder
authors.forename: Roger G
authors.initials: RG
authors.lastname: Faix
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.forename: Kurt R
authors.initials: KR
authors.lastname: Schibler
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Newman
authors.forename: Wade
authors.initials: W
authors.lastname: Rich
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: Michele C
authors.initials: MC
authors.lastname: Walsh
mesh_terms: D000367:Age Factors; D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis* / Q000401:mortality; D005006:Ethnicity; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D015233:Models, Statistical; D044469:Racial Groups; D012307:Risk Factors; D012737:Sex Factors