Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Incidence and Risk Factors of Bronchopulmonary Dysplasia in Premature Infants Below 32 Weeks of Gestation

Document Type : Original Article

Authors
Kamaran Omara Hama karim 1
Alan abdulla abdurahman 2
1 Clinical Science Branch, College of Medicine, University of Sulaimani, Kurdistan Region of Iraq.
2 Associate Professor, Clinical Science Branch, College of Medicine, University of Sulaimani, Kurdistan Region of Iraq.
10.22038/psj.2025.90997.1488
Abstract
Introduction:
Bronchopulmonary dysplasia (BPD) remains a major cause of morbidity in preterm infants, particularly those born at <32 weeks of gestation. This study aimed to determine the incidence and severity of BPD and identify associated risk factors in a high-risk neonatal population in Sulaimaniyah, Iraq.
Materials and Methods:
A retrospective observational study was conducted over 12 months (January–December 2025) across two tertiary NICUs. Preterm infants born at <32 weeks and admitted within 24 hours of birth were included. Data were extracted from medical records, and BPD was diagnosed and graded at 36 weeks’ postmenstrual age.
Results:
Twenty preterm infants were included. Most were male (70%) and had a birth weight between 500–999 g (70%). BPD incidence was 100%, with 16 (80%) cases classified as severe and 4 (20%) as moderate. Recurrent apnea was experienced by 10 (50%) infants and was the only factor significantly associated with BPD severity (p=0.043). Other factors, including gestational age, birth weight, mechanical ventilation, and antenatal steroid administration, showed no significant association. Logistic regression revealed no statistically significant predictors of BPD severity.
Conclusion:
The study found a high incidence of severe BPD among infants born before 32 weeks. Recurrent apnea was significantly associated with severe BPD, indicating a need for early detection and targeted interventions. Larger multicenter studies with extended follow-up are needed to validate these findings and better understand the multifactorial etiology of BPD.
Keywords
Apnea
Bronchopulmonary Dysplasia
Infant
Intensive Care Unit
Subjects
  1. Blencowe H, Hug L, Moller A-B, You D, Moran AC. Definitions, terminology and standards for reporting of births and deaths in the perinatal period: International Classification of Diseases (ICD-11). International Journal of Gynecology & Obstetrics. 2025;168(1):1-9. https://doi. org/10.1002/ijgo.15794.
  2. Dankhara N, Holla I, Ramarao S, Kalikkot Thekkeveedu R. Bronchopulmonary Dysplasia: Pathogenesis and Pathophysiology. Journal of clinical medicine. 2023;12(13):4207. https:// doi. org/10. 3390/jcm12134207.
  3. Hilgendorff A. Bronchopulmonary Dysplasia 2016 [Available from: https:// obgynkey.com/ bronchopulmonary-dysplasia-5/.
  4. Sahni M, Mowes AK. Bronchopulmonary Dysplasia. Treasure Island (FL) ineligible companies. Disclosure: Anja Mowes declares no relevant financial relationships with ineligible companies.2025.
  5. Jensen EA, Schmidt B. Epidemiology of bronchopulmonary dysplasia. Birth defects research Part A, Clinical and molecular teratology. 2014;100(3):145-57. https://doi. org/10. 1002/bdra.23235.
  6. González-Luis GE, van Westering-Kroon E, Villamor-Martinez E, Huizing MJ, Kilani MA, Kramer BW, et al. Tobacco Smoking During Pregnancy Is Associated With Increased Risk of Moderate/Severe Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis. Frontiers in pediatrics. 2020;8:160. https:// doi.org/ 10.3389/ fped.2020.00160.
  7. Dik PB, Gualdron YN, Galletti MF, Cribioli CM, Mariani GL. Bronchopulmonary dysplasia: incidence and risk factors. Arch Argent Pediatr. 2017;115(5):476-82.
  8. Sucasas Alonso A, Pértega Diaz S, Sáez Soto R, Avila-Alvarez A. Epidemiology and risk factors for bronchopulmonary dysplasia in preterm infants born at or less than 32 weeks of gestation. Anales de Pediatría (English Edition). 2022; 96(3):242-51. https:// doi.org/10. 1016/j. anpede. 2021. 03.006.
  9. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001; 163(7): 1723-9.10.1164/ajrccm.163.7.2011 060.
  10. Thébaud B, Goss KN, Laughon M, Whitsett JA, Abman SH, Steinhorn RH, et al. Bronchopulmonary dysplasia. Nat Rev Dis Primers. 2019;5(1):78. 10.1038/s41572-019-0127-7.
  11. Rutkowska M, Hożejowski R, Helwich E, Borszewska-Kornacka MK, Gadzinowski J. Severe bronchopulmonary dysplasia - incidence and predictive factors in a prospective, multicenter study in very preterm infants with respiratory distress syndrome. J Matern Fetal Neonatal Med. 2019;32(12):1958-64. 10.1080/ 14767058. 2017.1422711.
  12. Kwok TC, Poulter C, Algarni S, Szatkowski L, Sharkey D. Respiratory management and outcomes in high-risk preterm infants with development of a population outcome dashboard. thorax. 2023; 78(12):1215-22.
  13. Konzett K, Riedl D, Blassnig-Ezeh A, Gang S, Simma B. Outcome in very preterm infants: a population-based study from a regional center in Austria. Front Pediatr. 2024;12:1336469. 10.3389/ fped.2024. 1336469.
  14. Xu YP. Bronchopulmonary Dysplasia in Preterm Infants Born at Less Than 32 Weeks Gestation. Glob Pediatr Health. 2016; 3: 2333794x16668773. 10.1177/ 2333794 x16668773.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Solomakha AY, Petrova NA, Ivanov DO, Sviryaev YV. Apnea within the first year of life in premature infants with bronchopulmonary displasia and pulmonary hypertension. Pediatr. 2018;9(3):16-23. 10.17816/ped9316-23.
  2. Cicalò MI, Mellino ML, Pintus R, Marcialis MA, Fanos V. Bronchopulmonary dysplasia: the more we learn, the less we know. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM). 2023;12(1):e120113. 10.7363/120113.
  3. Qian X, Townsend M, Tan KWJ, Grenyer B. Sex differences in borderline personality disorder: A scoping review. PLOS ONE. 2022;17:e0279015. 10.1371/journal.pone.0279015.
  4. Dou C, Yu YH, Zhuo QC, Qi JH, Huang L, Ding YJ, et al. Longer duration of initial invasive mechanical ventilation is still a crucial risk factor for moderate-to-severe bronchopulmonary dysplasia in very preterm infants: a multicentrer prospective study. World J Pediatr. 2023; 19(6):577-85. 10.1007/ s12519-022-00671-w.
  5. Nawaytou H, Hills NK, Clyman RI. Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension. Pediatr Res. 2023; 94(2):547-54. 10.1038/s41390-023-02522-4.
Journal of Patient Safety & Quality Improvement
Volume 14, Issue 1
Winter 2026
Pages 41-49