BACKGROUND: Premature newborns experience intermittent hypoxemia (IH) events during their birth hospitalization. The objective of the study was to determine if IH event frequency and duration are associated with improved prediction of Bronchopulmonary Dysplasia (BPD) severity in Extremely Low Gestational Age Newborns (ELGANs, <29 weeks gestation). METHODS: saturation) lasting 10-300 seconds, with both frequency and duration recorded. BPD severity (primary outcome) was determined by the Neonatal Research Network (NRN) 2019 definition at 36 weeks' postmenstrual age. Multinomial regression models were generated and compared with the 2022 NRN BPD Estimator, with and without IH data, at postnatal days (PND) 7, 14, and 28. RESULTS: increased stepwise with BPD severity (p < 0.0001), whereas IH frequency was similar. BPD severity prediction models that included IH duration were improved for Grade 2 BPD at PND 28 (AUROC 0.79). CONCLUSIONS: Infants with worse BPD severity experience longer IH events. Some BPD severity predictions are enhanced when IH metrics are included. IMPACT: Intermittent hypoxemia event frequency and duration have distinct trajectories over time. Adding intermittent hypoxemia to bronchopulmonary dysplasia models based on the Neonatal Research Network 2019 definition enhances the prediction of BPD severity at postnatal day 28, suggesting bedside monitoring data can help distinguish BPD endotypes earlier in disease progression.
Wadhwa et al. (Thu,) studied this question.