Importance: Large-scale estimates of bronchopulmonary dysplasia (BPD) are warranted for adequate prevention and treatment. However, systematic approaches to ascertain global rates of BPD are lacking.
Objective: To conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤1,500 grams) or very low gestational age (\u3c32 \u3eweeks) neonates.
Data sources: A search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed.
Study selection: Randomized controlled trials and observational studies evaluating rates of BPD in very low birth weight or very low gestational age were eligible. Included studies defined BPD as positive pressure ventilation or oxygen requirement at 28 days (BPD28) or at 36 weeks postmenstrual age (BPD36).
Data extraction and synthesis: Two reviewers independently conducted all stages of the review. Random-effects meta-analysis was used to calculate the pooled prevalence. Subgroup analyses included gestational age group, birth weight group, setting, study period, continent, and gross domestic product. Meta-regression was performed to identify the impact of significant variables on study effect.
Main outcomes and measures: Prevalence of BPD defined as BPD28, BPD36, AnyBPD (BPD 28 or BPD 36), and by subgroups.
Results: A total of 82 articles and 696,881 patients were included in this review. The pooled prevalence was 23% (95% CI, 17%-30%) for BPD28 (n=29 studies, 101,848 neonates), 21% (95% CI, 17%-24%) for BPD36 (n=56 studies, 584,448 neonates), and 19% (95% CI, 16%-22%) for any BPD (n=70 studies, 607,653 neonates). In subgroup meta-analyses, birth weight was the strongest driver of the pooled prevalence of BPD.
Conclusions and relevance: This study provides a global estimation of BPD prevalence in very low birth weight/low gestation neonates
