The diagnostic criteria of bronchopulmonary dysplasia (BPD) have been reassessed based on current practices and highest accuracy in predicting long-term outcomes. We investigated the association between BPD severity based on different definitions in terms of long-term outcomes and pulmonary arterial hypertension (PAH). This retrospective study enrolled preterm infants born at <32 weeks of gestation. The definition of BPD recommended by the National Institutes of Health in 2001, National Institute of Child Health and Human Development (NICHD) in 2018, and Jensen et al. in 2019 were used. The association between re-hospitalization due to respiratory illness, neurodevelopmental impairment (NDI) at a corrected age of 18–24 months, and PAH at a postmenstrual age (PMA) of 36 weeks with the severity of BPD based on these three definitions were evaluated. Among 354 infants, gestational age (26.9 weeks) and birth weight (730 g) were lowest in severe BPD based on NIH 2001 definition. In total, 14.1% of study population experienced NDI and 19.0% were re-hospitalized due to respiratory illness. Multiple logistic regression analysis showed that the adjusted odds ratio (OR) for re-hospitalization was highest in grade-3 BPD of the Jensen (2019) criteria (7.45). The adjusted OR for NDI (13.23) and PAH (40.37) were also highest in grade-3 of the Jensen (2019) criteria.
Conclusion: Based on recently suggested criteria, severity of BPD is associated with long-term outcomes and PAH at PMA of 36 weeks in preterm infants.