{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T04:06:06Z","timestamp":1787457966751,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Off\u2010label treatment of extremely preterm infants with diuretics and inhaled corticosteroids (ICS) for evolving bronchopulmonary dysplasia (BPD) is common. Their effectiveness in reducing mortality or BPD severity, and optimal treatment timing, are unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine whether diuretic treatment or ICS administration for infants with early evolving (between 10\u201327\u2009days postnatal) and progressively evolving (28th\u2010day\u201336th\u2010week postnatal) BPD are independently associated with reduced mortality and moderate or severe BPD at 36\u2010weeks postmenstrual age (PMA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined neonates born before 28\u2009weeks' gestation and admitted to neonatal intensive care units on postnatal Day 0 between 2006 and 2016 using data collected during routine care recorded within the Paediatric Health Information System (PHIS). An early evolving BPD cohort consisted of infants treated with oxygen, positive pressure or mechanical ventilation at 10\u2009days postnatal. The progressively evolving BPD cohort consisted of infants treated with these modalities at 28\u2009days. In new users, we evaluated the effect of diuretic and ICS treatment on mortality or BPD severity at 36\u2009weeks PMA, adjusting for time\u2010dependent confounding by respiratory status using marginal structural models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Early evolving BPD was present in 10,135 patients; progressively evolving BPD in 11,728. New diuretic exposure during early evolving BPD (adjusted risk ratio [aRR] 0.77, 95% confidence interval [CI] 0.65, 0.93) was associated with decreased mortality or moderate\/severe BPD risk. New diuretics (aRR 0.86, 95% CI 0.75, 0.99) during progressively evolving BPD between 28\u2010days\u201336\u2010weeks PMA were less strongly associated with mortality or moderate\/severe BPD reduction. There was no strong association for ICS in patients with early evolving (aRR: 1.40; 95% CI: 0.79, 2.51) or progressively evolving BPD (aRR 1.16, 95% CI 0.95, 1.49).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diuretics, but not ICS, for evolving BPD were associated with mortality and BPD risk reduction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13038","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T04:49:07Z","timestamp":1704775747000},"page":"495-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Estimating the effect of diuretics and inhaled corticosteroids for evolving bronchopulmonary dysplasia in preterm infants"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6831-7520","authenticated-orcid":false,"given":"Jonathan L.","family":"Slaughter","sequence":"first","affiliation":[{"name":"Center for Perinatal Research The Research Institute at Nationwide Children's Hospital  Columbus Ohio USA"},{"name":"Department of Pediatrics The Ohio State University College of Medicine  Columbus Ohio USA"},{"name":"Division of Epidemiology, College of Public Health The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0513-4975","authenticated-orcid":false,"given":"Mark A.","family":"Klebanoff","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research The Research Institute at Nationwide Children's Hospital  Columbus Ohio USA"},{"name":"Department of Pediatrics The Ohio State University College of Medicine  Columbus Ohio USA"},{"name":"Division of Epidemiology, College of Public Health The Ohio State University  Columbus Ohio USA"},{"name":"Division of Obstetrics and Gynecology The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8977-6443","authenticated-orcid":false,"given":"Erinn M.","family":"Hade","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Population Health New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1835"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106838"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148188"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/neo.20-4-e189"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000143719"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1501917"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001969.pub4"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002311.pub5"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001453.pub2"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001817.pub2"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0249"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0055OC"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0620I"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2011.44"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg231"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181875e61"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000135174.63482.43"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.4354"},{"key":"e_1_2_13_20_1","volume-title":"Causal Inference: What If","author":"Her\u0144an M","year":"2020"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200009000-00011"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh131"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw341"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-3114"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn164"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv137"},{"key":"e_1_2_13_27_1","volume-title":"Modern Epidemiology","author":"Lash TL","year":"2021"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/m16-2607"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21554"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119482260"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-022-01320-w"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1203229"}],"container-title":["Paediatric and Perinatal Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ppe.13038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T01:26:39Z","timestamp":1724894799000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ppe.13038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,8]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/ppe.13038"],"URL":"https:\/\/doi.org\/10.1111\/ppe.13038","archive":["Portico"],"relation":{},"ISSN":["0269-5022","1365-3016"],"issn-type":[{"value":"0269-5022","type":"print"},{"value":"1365-3016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,8]]},"assertion":[{"value":"2023-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}