{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:38:40Z","timestamp":1777955920661,"version":"3.51.4"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T00:00:00Z","timestamp":1625184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The present study compared baseline characteristics, comorbidities and clinical burden of pre-term infants with type 1 and 2 severe bronchopulmonary dysplasia (BPD) Collaborative classification.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This study was a prospective cohort study of pre-term (&amp;lt;32 weeks) very-low-birth-weight infants. Severe BPD was divided into type 1 severe BPD requiring of \u226530% oxygen and\/or non-invasive ventilation at 36 weeks post-menstrual age (PMA), and type 2 severe BPD requiring invasive mechanical ventilation at 36 weeks PMA. Baseline characteristics, comorbidities, and clinical burden were compared between these two types of severe BPD.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Of the 1,328 infants included, 983 (74.0%) developed type 1 severe BPD, and 345 (26.0%) developed type 2 severe BPD. Lower birth weight, small for gestational age, lesser maternal pre-mature rupture of membrane, lower 5-min Apgar score, air leak, pulmonary hemorrhage, surgical ligation of patent ductus arteriosus, necrotizing enterocolitis, and late-onset sepsis were significantly associated with type 2 severe BPD. Compared with infants with type 1 severe BPD, infants with type 2 severe BPD had an increased risk of mortality (aOR 18.64, 95% CI 10.81\u201332.13), pulmonary hypertension (aOR 2.16, 95% CI 1.59\u20132.93), and tracheostomy (aOR 10.38, 95% CI 2.05\u201352.49).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our data highlight the substantially greater mortality and clinical burden in infants with type 2 severe BPD than infants with type 1 severe BPD. A comprehensive and multidisciplinary approach is needed for infants with type 2 severe BPD.<\/jats:p>","DOI":"10.3389\/fped.2021.664033","type":"journal-article","created":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T05:24:15Z","timestamp":1625203455000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Differences in Comorbidities and Clinical Burden of Severe Bronchopulmonary Dysplasia Based on Disease Severity"],"prefix":"10.3389","volume":"9","author":[{"given":"Hye-Rim","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Hwa","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beyong Il","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Won","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1513\/AnnalsATS.201504-218OC","article-title":"Comparisons and limitations of current definitions of bronchopulmonary dysplasia for the prematurity and respiratory outcomes program","volume":"12","author":"Poindexter","year":"2015","journal-title":"Ann Am Thorac."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","article-title":"Bronchopulmonary dysplasia","volume":"163","author":"Jobe","year":"2001","journal-title":"Am J Respir Crit Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1542\/peds.2005-0249","article-title":"Validation of the national institutes of health consensus definition of bronchopulmonary dysplasia","volume":"116","author":"Ehrenkranz","year":"2005","journal-title":"Pediatrics."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e727","DOI":"10.1542\/peds.2012-2990","article-title":"Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home","volume":"132","author":"Cristea","year":"2013","journal-title":"Pediatrics."},{"key":"B5","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1016\/j.jpeds.2004.03.026","article-title":"Rehospitalization in the first year of life among infants with bronchopulmonary dysplasia","volume":"144","author":"Smith","year":"2004","journal-title":"J Pediatr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1001\/jama.289.9.1124","article-title":"Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms","volume":"289","author":"Schmidt","year":"2003","journal-title":"JAMA."},{"key":"B7","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1053\/j.semperi.2006.05.010","article-title":"Neurodevelopmental outcome of bronchopulmonary dysplasia","volume":"30","author":"Anderson","year":"2006","journal-title":"Semin Perinatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1111\/j.1469-8749.2007.02011.x","article-title":"Bronchopulmonary dysplasia predicts adverse developmental and clinical outcomes in very-low-birth-weight infants","volume":"50","author":"Jeng","year":"2008","journal-title":"Dev Med Child Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jpeds.2016.10.082","article-title":"Interdisciplinary care of children with severe bronchopulmonary dysplasia","volume":"181","author":"Abman","year":"2017","journal-title":"J Pediatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1055\/s-0035-1547326","article-title":"Point prevalence, clinical characteristics, and treatment variation for infants with severe bronchopulmonary dysplasia","volume":"32","author":"Guaman","year":"2015","journal-title":"Am J Perinatol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1164\/rccm.201812-2348OC","article-title":"The diagnosis of bronchopulmonary dysplasia in very preterm infants. 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