Risk Factors in Bronchopulmonary Dysplasia

描述(由申请人提供)：此申请是为了继续我们对支气管肺发育不良(BPD)和其他极低出生体重(VLBW)婴儿和儿童(VLBW，&lt；1500 g)新生儿条件的不断演变的危险因素和结果的长期研究。建议全面记录2003年和2004年在威斯康星州出生的所有极低出生体重儿的新生儿和儿童早期病程和结局(每年800-850人)，使用现有的方法和增加的危险因素信息来检验目前提出的BPD病因学的炎症性假说。这项研究还将实施和验证最近由NIH研讨会开发的BPD严重程度的新诊断标准。 对所有2岁的儿童和2003年出生的4岁儿童进行脉冲振荡仪(LOS)测试的全面随访，将产生关于极小新生儿存活时代NICU结果的地区数据。LOS是一种敏感的方法，特别适合于儿童使用来测量呼吸道功能。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未选定VLBW婴儿的全面结局图，(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)确定未来干预的高危亚组，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.