Risk Factors in Bronchopulmonary Dysplasia

描述（由申请人提供）：本申请是为了继续我们长期以来在支气管肺发育不良（BPD）和极低出生体重（VLBW，<1500 g）婴儿和儿童的其他新生儿疾病的风险因素和结局方面的研究。建议全面记录2003年和2004年（每年800-850例）期间威斯康星州所有VLBW出生的新生儿和幼儿期病程和结局，使用已建立的方法和增加的风险因素信息，检查目前提出的BPD病因的炎症假说。该研究还将实施和验证最近NIH研讨会制定的BPD严重程度的新诊断标准。 对所有2岁以下的儿童以及2003年出生的4岁时接受脉冲多普勒（IOS）检测的儿童进行全面随访，将生成关于极小新生儿存活时代NICU结局的区域数据。LOS是一种敏感的方法，特别适用于儿童以测量气道功能。这项研究对临床实践很重要，因为它将：（1）提供在当前护理时代出生的极低出生体重婴儿的结果的全面描述，（2）检查假设演变为BPD和其他并发症的炎症过程的现成标记物，（3）识别未来干预的高风险亚组，以及（4）产生关于临床实践的假设，以通过随机试验进行检验。

DESCRIPTION (provided by applicant): This application is to continue our long-standing research in the evolving risk factors and outcomes of bronchopulmonary dysplasia (BPD) and other neonatal conditions of very low birth weight (VLBW, < 1500g) infants and children. It is proposed to comprehensively document the neonatal and early childhood course and outcomes of all VLBW births in Wisconsin occurring during the calendar years 2003 and 2004 (800-850 per year), using established methodology with added risk factor information to examine currently proposed inflammatory hypotheses of BPD etiology. The research will also implement and validate new diagnostic criteria for the severity of BPD developed by a recent NIH workshop. Comprehensive follow-up of all children to age 2, and those born in 2003 to impulse oscillometry (lOS) testing at age 4 years, will generate regional data on NICU outcomes in an era when extremely small neonates survive. lOS is a sensitive method that is especially appropriate for use in children to measure the function of the airways. The research is important to clinical practice as it will: (1) provide a comprehensive picture of the outcomes of unselected VLBW infants born in the present era of care, (2) examine a readily available marker for the inflammatory process hypothesized to evolve into BPD and other complications, (3) identify high risk sub-groups for future interventions, and (4) generate hypotheses regarding clinical practice to be tested by randomized trials.