However, in a few studies, this was not explicitly stated thus, it was unknown whether the calculation included all live-born infants, regardless of whether they survived to 36 weeks PMA, in which case the incidence would be underestimated. In calculating BPD incidence, most studies considered only infants alive at 36 weeks PMA in the denominator. Most studies defined BPD as the requirement of supplemental oxygen at 36 weeks postmenstrual age (PMA) although, there were variations from this definition. No data were found on the incidence or prevalence of BPD among infants in Africa or South America. Additionally, two publications included data from both Europe and North America, and one publication included stratified data from both Asia and North America. Reported data came from 37 publications from Europe (23 distinct data sources), 38 publications from North America (19 data sources), 19 from Asia (16 data sources), and six from Oceania (Australia and New Zealand six data sources). Hence, we undertook this systematic literature review to examine incidence estimates for BPD in infants born extremely preterm, and to establish ranges for global incidence. Īn awareness of BPD incidence can aid in the counseling of parents and caregivers of preterm infants, the development of clinical guidelines, and the design of clinical studies of new treatments. Uncertainty in the temporal trend of BPD epidemiology reflects a confluence of circumstances such as differences in the BPD definition, increased survival among the immature infants who are inherently predisposed to BPD, differential use of oxygen therapy, and the potential for targeted use of dexamethasone and adjunctive vitamin A to reduce the risk of BPD. Modest reductions in the incidence of several comorbidities of prematurity have also accompanied these improved practices, with the exception of BPD incidence, which has remained steady or increased over time depending on country/geographic region.

Survival to discharge of extremely preterm infants has improved in recent years, particularly in highly developed countries, due to advances in neonatal care such as antenatal corticosteroid use, less aggressive ventilation, and strict infection control practices. Preterm infants with BPD have prolonged hospital stays, high healthcare costs, and long-term pulmonary morbidity.

Bronchopulmonary dysplasia (BPD) is the most common morbidity of prematurity, which occurs when the alveolarization process – the final stage of lung development – is disrupted.

Those who survive are susceptible to serious neonatal morbidities strongly associated with poor long-term outcomes. Infants born extremely preterm, defined as birth <28 weeks gestational age (GA), face a high risk of neonatal mortality.

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