Supplementary Material for: Identifying Risk Factors Shared by Bronchopulmonary Dysplasia, Severe Retinopathy, and Cystic Periventricular Leukomalacia in Very Preterm Infants for Targeted Intervention

Background: Bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (sROP), and cystic periventricular leukomalacia (cPVL) are 3 major morbidities with long-term neurodevelopmental impairments in preterm infants. Objective: To investigate the strength of associations and identify key risk factors shared by BPD, sROP, and cPVL for targeted intervention. Methods: We studied the Taiwanese very-preterm-infant registry data on 3,507 infants admitted to neonatal intensive care units and discharged at postmenstrual age ≥36 weeks between 2008 and 2013. Results: Of 3,507 infants, 1,497 presented with at least 1 morbidity (26 [1.7%], 386 [25.8%], and 1,085 [72.5%] exhibited 3, 2, and 1 morbidities, respectively). BPD was strongly associated with sROP (odds ratio 5.93; 95% confidence interval 5.02–7.03), followed by cPVL (2.08; 1.63–2.64), but sROP and cPVL were weakly associated (1.59; 1.17–2.13). Most risk factors contributed to BPD, which shared risk factors with sROP and cPVL. A birth weight of Conclusions: BPD and sROP were most strongly associated. Most risk factors contributed to BPD, with differentially shared effects on sROP and cPVL. Prolonged MV was the only risk factor shared by all 3 morbidities, and avoiding it potentially reduced the risk of having at least 1 of them.

背景：支气管肺发育不良（Bronchopulmonary dysplasia, BPD）、早产儿重度视网膜病变（severe retinopathy of prematurity, sROP）以及脑室周围白质软化症（cystic periventricular leukomalacia, cPVL）是早产儿三大主要并发症，均可导致长期神经发育障碍。研究目的：探究支气管肺发育不良、早产儿重度视网膜病变与脑室周围白质软化症三者间的关联强度，并明确三者共有的关键危险因素以开展针对性干预。研究方法：本研究纳入2008年至2013年间收治于新生儿重症监护病房、最终于经后胎龄≥36周时出院的3507名极早产儿的中国台湾地区登记队列数据进行分析。研究结果：3507名早产儿中，共1497名至少罹患1种目标并发症，其中分别有26名（1.7%）、386名（25.8%）及1085名（72.5%）同时患有3种、2种及1种并发症。支气管肺发育不良与早产儿重度视网膜病变关联最强（比值比OR=5.93；95%置信区间CI：5.02~7.03），其次为与脑室周围白质软化症（OR=2.08；95%CI：1.63~2.64）；而早产儿重度视网膜病变与脑室周围白质软化症的关联较弱（OR=1.59；95%CI：1.17~2.13）。多数危险因素与支气管肺发育不良相关，三者共享部分危险因素。结论：支气管肺发育不良与早产儿重度视网膜病变的关联最为显著。多数危险因素与支气管肺发育不良相关，且对早产儿重度视网膜病变及脑室周围白质软化症存在差异化的共通影响。长时间机械通气（Prolonged MV）是三种并发症共有的唯一危险因素，规避该因素或可降低早产儿至少罹患1种上述并发症的风险。