title: Infants born at <29 weeks: pulmonary outcomes from a hybrid perinatal system.
abstract: OBJECTIVE
  To assess pulmonary outcomes of infants <29 weeks gestational age (GA), delivered at level I, II and III facilities, to identify potentially modifiable factors affecting bronchopulmonary dysplasia (BPD) severity and to assess the external generalizability of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) BPD Outcome Estimator.
  
  
  METHODS
  Outcomes for infants <29 weeks GA born during (2008-2010) and delivered either at an inborn level III center or in a level II or III metropolitan area hospital with transfer to a level IV center, or delivered in a distant level I or II center and then transported to a level IV center were assessed. BPD severity was compared with the NICHD Neonatal BPD Outcome Estimator.
  
  
  RESULTS
  Of 158 infants who comprised the cohort, 28 (17.8%) had no BPD, 39 (24.2%) had mild BPD, 45 (28.7%) had moderate BPD, 31 (19.7%) had severe BPD and 15 (9.6%) died at ≤36 weeks post menstrual age. Site of birth did not predict severe BPD or death. Receiver operator characteristic curves showed fair predictability for none/mild and severe BPD.
  
  
  CONCLUSIONS
  BPD severity was not dependent on site of birth. The NICHD BPD outcome estimator provides fair prediction for extreme outcomes.
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: W E
authors.initials: WE
authors.lastname: Truog
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: M F
authors.initials: MF
authors.lastname: Nyp
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: J
authors.initials: J
authors.lastname: Taylor
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Gratny
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: H
authors.initials: H
authors.lastname: Escobar
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: W M
authors.initials: WM
authors.lastname: Manimtim
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: C I
authors.initials: CI
authors.lastname: Lachica
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: A
authors.initials: A
authors.lastname: Khmour
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: O O
authors.initials: OO
authors.lastname: Oluola
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Oshodi
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: M
authors.initials: M
authors.lastname: Norberg
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: H
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Center for Infant Pulmonary Disorders, University of Missouri-Kansas City School of Medicine, Kansas, MO, USA.
authors.forename: E K
authors.initials: EK
authors.lastname: Pallotto
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000145:classification / Q000453:epidemiology* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index