Characteristics and Outcomes of Infants with Severe Bronchopulmonary Dysplasia Admitted to BPD Collaborative Centers

Characteristics and Outcomes of Infants with Severe Bronchopulmonary Dysplasia Admitted to BPD Collaborative Centers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Characteristics and Outcomes of Infants with Severe Bronchopulmonary Dysplasia Admitted to BPD Collaborative Centers Pamela Griffiths, Matthew Kielt, Milenka Cuevas Guaman, Jonathan Levin, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8870533/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objective To describe key clinical features and outcomes for infants with grade 2-3 bronchopulmonary dysplasia (sBPD) enrolled in interdisciplinary BPD programs. Study Design An observational multi-center retrospective study of infants hospitalized in BPD Collaborative centers with grade 2-3 BPD from 2015-2024. Results Of 1747 infants, 29.2% had grade 3 BPD. Survival was high (95.4%) but accompanied by high need for respiratory support (68.2%), technology dependence (13.0% tracheostomy, 38.7% gastrostomy, 49.6% supplemental feeds), and respiratory medications at discharge (55% on inhaled medication). Median length of stay (LOS) and postmenstrual age (PMA) at discharge were 130 (94, 183) days and 47 (42, 54) weeks. Conclusion Despite high in-hospital survival of infants with sBPD who were enrolled in interdisciplinary BPD programs, most require high levels of support at discharge. Future studies are needed to identify targeted interventions that reduce the burden of care for infants with sBPD at the time of birth hospitalization discharge. Health sciences/Health care/Paediatrics Health sciences/Medical research/Epidemiology Figures Figure 1 Figure 2 Introduction Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory morbidity affecting preterm infants and typically follows treatments with oxygen and ventilator support for acute respiratory distress after birth. 1 Those with the most severe forms of BPD, particularly infants who experience a protracted course of invasive ventilation, often have extensive co-morbidities and chronic medical needs. In addition to care from neonatologists and pulmonologists, these infants often require care from subspecialists for management of pulmonary hypertension (PH), airway abnormalities, retinopathy of prematurity, nutrition, metabolic bone disease, and growth failure. Achieving optimal developmental progress is challenging and requires an integrated approach that includes goal-directed developmental therapies and adequate respiratory support to promote patient comfort and an interactive state. 2 To address the complex medical and psychosocial needs of infants with severe BPD, interdisciplinary care programs have been developed that integrate pediatric sub-specialists, physical and occupational therapists, speech pathologists, dietitians, pharmacists, respiratory therapists, developmental specialists, and social workers. 3 Single-center studies of interdisciplinary BPD programs suggest that infants enrolled in these programs experience high rates of survival, short-term improvements in catch-up growth, low rates of hospital readmission, and favorable neurodevelopmental outcomes. 4 – 7 Whether the favorable outcomes observed in single-center interdisciplinary BPD program studies are generalizable across centers remains unknown. In 2012, the BPD Collaborative was formed to leverage the experience of centers with interdisciplinary BPD care programs to address knowledge gaps in the evidence-based care of infants with severe BPD. The BPD Collaborative advances interdisciplinary collaboration through data sharing between centers in the form of a patient registry that characterizes patient demographics, management, and late outcomes for both inpatient and outpatient care. The objective of this study is to leverage the BPD collaborative registry to characterize clinical features and outcomes of infants with grade 2–3 BPD to identify areas for future investigation aimed at improving sBPD outcomes. Methods Study Population The BPD Collaborative is comprised of academic medical centers with interdisciplinary BPD programs who contribute to a retrospective registry of de-identified patients born < 32 weeks gestation with grades 2 and 3 BPD per Neonatal Research Network (NRN) “Jensen” criteria 8 . The registry includes demographic data and clinical data for specific time points: 7 and 28 days of age, 36-, 44-, and 50-weeks postmenstrual age (PMA), and at death or discharge. Infants are enrolled locally at varying PMA based on admission, ranging from birth in hospitals who have obstetrical services to beyond term-corrected PMA due to severe established BPD. Eligible study subjects included infants enrolled in the BPD Collaborative inpatient registry between January 1, 2015 – September 30, 2024. Infants for whom finalized demographic data were available were eligible for this study. Additional inclusion criteria included 1) BPD grade 2 or 3, 2) gestational age (GA) < 32 weeks, 3) complete disposition data, and 4) age at admission < 1000 days. At the time of analysis, 18 BPD Collaborative centers with patients meeting inclusion criteria were represented in the study: Arkansas Children’s Hospital, Boston Children’s Hospital, C.S Mott Children’s Hospital of Michigan, Children’s Hospital of Philadelphia, Children’s Mercy Kansas City, Children’s Hospital Los Angeles, Riley Children’s Hospital at IU Health, Joe DiMaggio Children’s Hospital, Le Bonheur Children’s Hospital, Nationwide Children’s Hospital, Penn State Health Children’s Hospital, Phoenix Children’s, Saitama Medical Center (Japan), Texas Children’s Hospital, The Woman’s Hospital of Texas, University of Massachusetts Memorial Medical Center, Vanderbilt University Medical Center, and Women and Infants Hospital of Rhode Island. Each contributing hospital obtained Institutional Review Board oversight and approval from their respective institutions to participate in the BPD Collaborative registry. This is a descriptive report of the inpatient registry; an outpatient registry is also maintained but is not described here. Clinical Characteristics Clinical characteristics collected from study subjects included: maternal demographics, neonatal characteristics at birth, and respiratory support and medication exposure at 7 and 28 days after birth, 36-, 44-, and 50-weeks PMA, and at discharge. Weight was recorded at birth, 36 weeks PMA, and discharge, whereas length was only available at birth and discharge. Patients were classified as grade 3 BPD if they were treated with invasive mechanical ventilation at 36 weeks PMA. Invasive ventilation includes the following modalities: positive end-expiratory pressure with pressure support, conventional ventilation, high frequency ventilation, and invasive neurally adjusted ventilatory assist (NAVA). Non-invasive positive pressure ventilation includes nasal continuous positive airway pressure (CPAP), nasal intermittent positive pressure ventilation (NIPPV), synchronized intermittent positive airway pressure (SiPAP), bilevel positive airway pressure (BiPAP), and non-invasive-NAVA. Demographic data were stratified by BPD classification (Grade 2 or 3). Study Outcomes Primary study outcomes were stratified by survivors and non-survivors and included: BPD Grade at 36 weeks PMA, gastrostomy, tracheostomy, length of stay (LOS), PMA, and Z-scores for weight and length at the time of discharge or death. Fenton growth curves were used for Z-score calculations for patients < 50 weeks PMA at discharge. 9 World Health Organization (WHO) growth curves were used for Z-score calculations for patients ≥ 50 weeks PMA at discharge. 10 Statistical Analysis Standard descriptive statistics for the cohort are presented as median with interquartile range (IQR) for continuous data and number (n) with percentage (%) for categorical data. Survival was compared using Wilcoxon rank sum for continuous variables or Pearson’s chi-squared test for categorical variables. Following best statistical practice and STROBE reporting guidelines, p-values are not presented in the descriptive tables. 11 Missing data are noted in tables and analysis included only infants with available data. Statistical analysis was performed using R version 4.1.2 (R Foundation for Statistical Computing, Vienna, Austria). 12 Results Study Cohort Overall, 2512 infants had finalized demographic data. Of these, 1747 had BPD grade 2 or 3 and discharge data and were included in the analysis (Fig. 1 ). Data availability for clinical measures at specified timepoints varied from 638 patients at 50 weeks PMA to 1747 patients at 36 weeks PMA. Patient characteristics Demographics and early neonatal characteristics are reported for the overall cohort and stratified by BPD grade (Table 1 ). Across the overall cohort, mothers had a median age of 29 years and the following demographic distribution: 53.2% White, 32.3% Black/African American, 3.0% Asian, and 6.5% Other, with 11.3% of Hispanic or Latino ethnicity. American Indian or Alaskan Native and Native Hawaiian or Other Pacific Islander races were combined into the “Other” classification. Most mothers (85.8%) received at least one dose of antenatal corticosteroids, and 13.5% had a diagnosis of chorioamnionitis. Males represented 56.4% of infants in the cohort. The median birth gestation was 25 (24, 27) weeks, median birth weight was 738 (600, 930) g, and median birth length was 32 (30, 35) cm, with 18.9% of infants born small for gestational age (SGA). For the overall cohort, median age at time of admission to a BPD center was 10 (0, 42) days with a corresponding median PMA of 28 (25, 32) weeks (Table 1 ). At 36 weeks PMA, 29.1% of the cohort was classified as grade 3 BPD. Table 1 Demographic and clinical characteristics stratified by BPD Grade Characteristic Overall N = 1,747 Jensen Grade 2 N = 1,237 Jensen Grade 3 N = 510 Maternal age N 1,661 1,187 474 Median (IQR) 29 (24, 33) 29 (24, 33) 29 (25, 34) Maternal Race Asian 52 / 1,747 (3.0%) 43 / 1,237 (3.5%) 9 / 510 (1.8%) Black or African American 565 / 1,747 (32.3%) 392 / 1,237 (31.7%) 173 / 510 (33.9%) White 929 / 1,747 (53.2%) 663 / 1,237 (53.6%) 266 / 510 (52.2%) Other 113 / 1,747 (6.5%) 75 / 1,237 (6.1%) 38 / 510 (7.5%) Unknown 88 / 1,747 (5.0%) 64 / 1,237 (5.2%) 24 / 510 (4.7%) Maternal Ethnicity Hispanic or Latino 197 / 1,747 (11.3%) 139 / 1,237 (11.2%) 58 / 510 (11.4%) Not Hispanic or Latino 1,402 / 1,747 (80.3%) 985 / 1,237 (79.6%) 417 / 510 (81.8%) Unknown 148 / 1,747 (8.5%) 113 / 1,237 (9.1%) 35 / 510 (6.9%) Prenatal Corticosteroids 1,376 / 1,603 (85.8%) 977 / 1,152 (84.8%) 399 / 451 (88.5%) Maternal Chorioamnionitis 232 / 1,724 (13.5%) 173 / 1,225 (14.1%) 59 / 499 (11.8%) Cesarean Delivery 1,285 / 1,747 (73.6%) 900 / 1,237 (72.8%) 385 / 510 (75.5%) Male sex 983 / 1,742 (56.4%) 687 / 1,233 (55.7%) 296 / 509 (58.2%) Obstetrical gestational age 25 (24, 27) 26 (24, 27) 25 (24, 26) Birth weight (g) 738 (600, 930) 762 (615, 955) 670 (563, 841) Fenton birth weight z-score N 1,739 1,231 508 Median (IQR) -0.2 (-1.0, 0.4) -0.2 (-0.9, 0.4) -0.5 (-1.3, 0.3) Birth length (cm) N 1,596 1,158 438 Median (IQR) 32 (30, 35) 32 (30, 35) 31 (29, 33) Fenton birth length z-score N 1,535 1,113 422 Median (IQR) -0.4 (-1.2, 0.2) -0.3 (-1.2, 0.3) -0.7 (-1.5, 0.2) Birth Head Circumference (cm) N 1,582 1,148 434 Median (IQR) 22.8 (21.0, 24.5) 23.0 (21.2, 24.9) 22.0 (21.0, 24.0) Fenton birth HC z-score N 1,525 1,106 419 Median (IQR) -0.5 (-1.2, 0.2) -0.4 (-1.2, 0.2) -0.5 (-1.4, 0.2) SGA 328 / 1,739 (18.9%) 198 / 1,231 (16.1%) 130 / 508 (25.6%) Intubated in Delivery Room 1,200 / 1,743 (68.8%) 793 / 1,234 (64.3%) 407 / 509 (80.0%) PMA at admission (weeks) 28 (25, 32) 28 (25, 31) 29 (25, 33) CA at admission to BPD center 10 (0, 42) 9 (0, 35) 15 (0, 59) SGA, small for gestational age; PMA, postmenstrual age; CA, chronologic age Primary study outcomes: Conditions at discharge or death In-hospital outcomes were stratified by disposition (discharge to home/foster care/care facility, or death) (Table 2 ). We observed a survival rate of 95.4% during the data collection window. Compared to survivors at discharge, a greater proportion of non-survivors were designated Grade 3 BPD (79.0% vs 26.8%, p < 0.001) and had lower length z-scores at death (-3.8 vs − 1.7, p < 0.001). A greater proportion of non-survivors underwent tracheostomy (40.7% vs 13.0%, p < 0.001), while similar proportions underwent gastrostomy (34.8% and 38.7% for non-survivors and survivors, respectively, p = 0.5). The median LOS for the overall cohort was 130 (94, 185) days; the median chronologic age at death or discharge was 153 (119, 209) days, with a corresponding PMA of 46 (42, 54) weeks. Compared to survivors, non-survivors had a similar LOS (p = 0.2) and were older at disposition, with a chronologic age of 185 (126, 308) days (p = 0.004) and corresponding PMA of 51 (43, 70) weeks at time of death (p = 0.003). Discharge disposition was to home or foster care for 1,554 (89%) infants and to a care facility for 112 (6.4%) (Table 3 ). Table 2 Primary outcomes for the overall cohort, stratified by survival Characteristic Overall N = 1,747 Survivors 1 , N = 1,666 Deceased N = 81 p-value BPD Grade < 0.001 2 Jensen Grade 2 1,237 / 1,747 (70.8%) 1,220 / 1,666 (73.2%) 17 / 81 (21.0%) Jensen Grade 3 510 / 1,747 (29.2%) 446 / 1,666 (26.8%) 64 / 81 (79.0%) Tracheostomy 250 / 1,747 (14.3%) 217 / 1,666 (13.0%) 33 / 81 (40.7%) < 0.001 2 Gastrostomy tube 662 / 1,718 (38.5%) 639 / 1,652 (38.7%) 23 / 66 (34.8%) 0.5 2 Discharge weight z-score , n 1,719 1,640 79 0.2 3 Median (IQR) -0.7 (-1.5, 0.0) -0.7 (-1.4, 0.0) -1.2 (-2.4, 0.3) Discharge length z-score , n 1,678 1,608 70 < 0.001 3 Median (IQR) -1.7 (-2.7, -0.8) -1.7 (-2.6, -0.8) -3.8 (-5.1, -2.6) Discharge head circumference z-score , n 1,063 1,028 35 Median (IQR) -0.8 (-1.5, -0.1) -0.8 (-1.5, -0.1) -1.3 (-2.5, 0.3) 0.3 3 PMA at hospital discharge (weeks), n 1,747 1,666 81 0.003 3 Median (IQR) 46 (42, 54) 46 (42, 54) 51 (43, 70) Hospital Discharge Age , n 1,747 1,666 81 0.004 3 Median (IQR) 153 (119, 209) 152 (119, 208) 185 (126, 308) Length of Stay , n 1,747 1,666 81 0.2 3 Median (IQR) 130 (94, 185) 130 (94, 183) 135 (91, 263) 1 Survivors include infants discharged home, to foster care, or to another care facility; 2 Pearson Chi-squared, 3 Wilcoxon rank sum N = 1,666 at each time point. Specific counts are in Supplementary Table 1. Table 3 Respiratory support, medications, and enteral feeding at discharge or death Characteristic Overall N = 1,747 Survivors 1 N = 1,666 Deceased N = 81 Discharge Respiratory Support Room Air 464 / 1,747 (26.6%) 462 / 1,666 (27.7%) 2 / 81 (2.5%) LFNC 915 / 1,747 (52.4%) 915 / 1,666 (54.9%) 0 / 81 (0.0%) Non-invasive Positive Pressure 17 / 1,747 (1.0%) 16 / 1,666 (1.0%) 1 / 81 (1.2%) Invasive Positive Pressure 243 / 1,747 (13.9%) 169 / 1,666 (10.1%) 74 / 81 (91.4%) Trach Collar 37 / 1,747 (2.1%) 37 / 1,666 (2.2%) 0 / 81 (0.0%) Not recorded 71 / 1,747 (4.1%) 67 / 1,666 (4.0%) 4 / 81 (4.9%) Medications Pulmonary Vasodilators 85 / 1,622 (5.2%) 85 / 1,622 (5.2%) Systemic Corticosteroid 2 223 / 1,622 (13.7%) 223 / 1,622 (13.7%) Any Inhaled Medications 3 894 / 1,622 (55.1%) 894 / 1,622 (55.1%) Inhaled corticosteroids 820 / 1,622 (50.6%) 820 / 1,622 (50.6%) Beta agonist 740 / 1,622 (45.6%) 740 / 1,622 (45.6%) Diuretics 224 / 1,622 (13.8%) 224 / 1,622 (13.8%) Infant discharged on Full Enteral Nutrition (tube or oral feeding ) Yes 1,582 / 1,747 (90.6%) 1,566 / 1,666 (94.0%) No 133 / 1,747 (7.6%) 88 / 1,666 (5.3%) Unknown 32 / 1,747 (1.8%) 12 / 1,666 (0.7%) Infant discharged on PO feeds (full or partial oral feeding) None 482 / 1,747 (27.6%) 423 / 1,666 (25.4%) Some 404 / 1,747 (23.1%) 403 / 1,666 (24.2%) All 829 / 1,747 (47.5%) 829 / 1,666 (49.8%) Unknown 32 / 1,747 (1.8%) 11 / 1,666 (0.7%) 1 Survivors include infants discharged home, to foster care, or to another care facility 2 Defined by combining use of Dexamethasone, Hydrocortisone, Prednisolone, Prednisone 3 Any inhaled medication includes beta agonist, inhaled corticosteroids Secondary outcomes: Respiratory, pharmacologic, and nutritional support A descriptive summary of respiratory support for survivors during their hospital stay is shown in Fig. 2 (Supp Table 1 ). The percentage of infants receiving invasive respiratory support declined over the measured registry time points from 51% and 52% at 7- and 28-days following birth, respectively, to 29% at 36 weeks PMA and 25% (257/1041) at 44 weeks PMA, but was higher with 32% (184/576) at 50 weeks PMA for those who remained admitted at each time point (Fig. 2 ). At disposition, 69.4% (1212/1747) were receiving respiratory support, most by low flow nasal cannula (52.4%), followed by room air (RA) in 26.6%, invasive positive pressure ventilation (IPPV) in 13.9%, trach collar (TC) in 2.1%, and NIPPV in 1.0% (Table 3 ). Medication use at discharge among survivors included inhaled corticosteroids in 50.6%, inhaled beta agonists in 45.6%, diuretics in 13.8%, systemic corticosteroids in 13.7%, and pulmonary vasodilators in 5.2%. Among all survivors at discharge, 49.8% were taking full oral feedings, 24.2% partial oral feeding, with 49% receiving supplemental tube feeding. Among those discharged to home or foster care, 52.9% took all oral feeds, whereas only 6.3% of those discharged to a care facility were taking all feeds by PO route (Supplemental Table 2). Discussion In this study, we describe the characteristics of a large contemporary cohort of 1747 infants with sBPD enrolled in 18 interdisciplinary BPD programs. While many NICUs will only treat a handful of these patients per year, this cohort is unique in that it provides insight into a large population of sBPD patients managed by highly interactive teams of clinicians and staff at various BPD Collaborative sites. In this high-acuity population, including 29% with grade 3 BPD, we observed a high rate of survival (95.4%). When compared to historical cohorts of infants with sBPD from the 1980’s-90’s with reported in-hospital survival rates of approximately 75%, 13–15 our study and others 8 , 16 – 18 demonstrate that in-hospital survival rates for infants with established sBPD have increased over time. The majority were discharged on nasal cannula or room air at a median PMA of 46 weeks and LOS of 130 days, outcomes most consider favorable. Despite this, these patients nonetheless remain at risk of ongoing respiratory and nutritional morbidity as evidenced by ongoing need for supplemental oxygen, tube feeding, and medication use at the time of hospital discharge observed in this cohort. The respiratory support needs in this cohort were significant, with 29%, 25%, and 32% of infants still hospitalized and receiving invasive positive pressure support at 36-, 44-, and 50-weeks PMA, respectively, consistent with greater disease severity in this unique cohort. In addition to the high percentage of patients discharged on respiratory support (68.2%, 1137/1666), supplemental feeds via nasogastric tube or gastrostomy further contribute to complexity of care. While infants with sBPD are known to have oral feeding difficulties, little data exists to describe oral feeding practices in infants with sBPD, especially among those with ongoing need for positive pressure respiratory support. 19 – 21 Our study found that only 49.8% of infants in the BPD Collaborative cohort took all feeds orally and 24.2% took partial volume by oral route by the time of discharge, leaving 50.2% dependent on either full or supplemental tube feeding, including those who received a gastrostomy tube. These findings highlight the need for prospective multicenter studies to assess the role of feeding routes on respiratory, growth, and developmental achievements, with emphasis on identifying infants with sBPD who are at highest risk for gastrostomy placement. Although infants with sBPD are exposed to multiple medications during their NICU hospitalization and through discharge, the evidence for routine administration of many of these medications is lacking, and their use across centers varies. 22 – 24 For survivors at discharge, we observed 50.6% use of inhaled corticosteroids, 45.6% beta agonists, 13.8% diuretics, 13.7% systemic steroids, and 5.2% pulmonary vasodilators. The relatively high frequency of use of inhaled medications in our cohort in the face of a paucity of evidence supporting its use also raises questions about factors contributing to prescribing practices. Investigation into patient characteristics, timing and indication for initiation, dose, and clinical response are needed to refine usage. 25 , 26 While representing only a small percentage (6.4%, 112/1747) of our cohort, those discharged to a care facility represent an especially fragile group. The majority were supported with invasive ventilation (66.1%) and had greater usage of all reported medications (pulmonary vasodilators, systemic steroids, inhaled corticosteroids, bronchodilators, and diuretics). This group likely represents both infants transferred to lower acuity transitional care units and those discharged to medical group homes, including those with ongoing educational needs and non-respiratory medical or social complexity. Data on clinical characteristics and outcomes of this population are lacking. One single-center study reported discharge to a chronic care facility for 11 of 102 subjects with sBPD requiring tracheostomy and long-term ventilation, 27 of which 4 were deceased by the time of publication. Further understanding of this cohort would allow for improved anticipatory guidance and inform future studies on optimizing transition of care for these patients. As expected, non-survivors were characterized by a greater severity of illness with a significantly greater proportion having grade 3 BPD and receiving tracheostomy. They also experienced worse linear growth than their surviving counterparts. Length of stay was like that of survivors, but final disposition occurred at older chronologic and postmenstrual ages, owing to their older age at admission to BPD Collaborative Centers. Murthy, et al 18,28 have previously described that those infants with sBPD who are referred later to Children’s Hospitals Neonatal Consortium (CNHC) centers experienced greater likelihood of death or tracheostomy. However, this finding was limited by referral bias, in which case infants with more severe disease are more likely to be referred to participating NICUs. The current cohort is also likely affected by referral bias, limiting the ability to draw conclusions related to timing of admission to a BPD center and outcomes. However, Sammour, et al 29 have reported lower rates of tracheostomy and LOS following implementation of routine consultation and evaluation by an interdisciplinary BPD program starting as early as 28 days of life and utilizing an individualized approach to adjusting respiratory support to avoid air trapping. This suggests that earlier recognition of changing lung physiology and adjustment of the ventilatory strategy may alter the disease course. Research focused on less mature infants with evolving BPD may ultimately have a profound impact on longer-term respiratory and developmental outcomes. A growing number of observational studies describe improved outcomes resulting from implementation of interdisciplinary BPD programs. Among the most complex and ill infants that require tracheostomy, improved survival has been reported following implementation of interdisciplinary teams. 4 , 5 Beyond survival, improved neurodevelopmental outcomes, growth, length of stay, outpatient visits, and readmissions have all been described following adoption of interdisciplinary care teams. 6 , 7 , 29 Unfortunately, evidence-based care practices that reduce morbidity and improve long-term outcomes in this growing and vulnerable population are wanting, owing to a paucity of research documenting individuals living with established severe BPD. Our results highlight the need for evidence-based strategies that not only improve survival but optimize long term respiratory outcomes and identify indications for prolonged respiratory support, nutritional support, and respiratory medications in the NICU and after discharge. While we report favorable infant outcomes, we must also consider the impact on families and caregivers who are continuing to care for medically fragile children following discharge. It is known that families of children with chronic diseases are more likely to experience healthcare-related quality of life impairment and that this risk is higher in those with more frequent respiratory symptoms and acute care utilization. 30 Many families may continue to struggle with difficulty navigating healthcare systems and accessing available community resources. 31 Strengths of this study include its large size, unique study population, and rich source of multicenter data from the BPD Collaborative. Additionally, we provide a longitudinal perspective on patterns of support received. A limitation of the current study is the descriptive, retrospective design, which lends the findings to generating hypotheses and informing future works. Additionally, generalizability may be limited as it is unclear if this is a representative population of grades 2 and 3 BPD patients. It is also likely that variability in demographics, practices, and outcomes exist between centers within this cohort, but this was not explicitly explored in this manuscript. The data presented in this descriptive study provides a perspective on the current state of care for infants with sBPD. Our results call attention to the ongoing need for further investigation in areas such as optimal medication usage, oral feeding practices, and ideal timing of respiratory support transitions. In addition, we note that many infants with sBPD are affected by complex medical needs at discharge. Efforts to improve discharge processes, family education, and health advocacy should remain a priority. We anticipate that the next ten years will yield exponential growth of our understanding of sBPD that can be leveraged to improve treatment and outcomes for affected infants. Conclusion Our multi-center BPD Collaborative registry study demonstrates that infants with established sBPD have high in-hospital survival rates, but a high burden of respiratory and nutritional support and medication use at birth hospitalization discharge. Extensive characterization of the clinical course of infants with severe BPD, especially related to late outcomes, may better inform clinical trial design for interventional strategies. Future studies are needed to advance knowledge and evidence-based practice for optimal care for infants with sBPD. Declarations Conflict of Interest: PSG: none; MJK none; MCG none; JCL none; SC none; SHA none; LDN none. Author contributions: PSG conceptualized the manuscript. MJK conducted the analyses. SC provided statistical support. MJK, JCL, and MCG interpreted the results of the analysis. All authors contributed data. SHA, LDN provided supervision, resources, and oversight. PSG wrote the initial draft of the manuscript; all authors reviewed the manuscript and approved its final version for submission. Funding None. Availability of Data and Materials: A de-identified dataset is available upon request. Acknowledgements: We would like to thank Victoria Bernaud and Stephanie Villa of the Phoenix Children’s Scientific Writing Core for their critical review and editing of the manuscript. Competing interests: The authors declare no competing interests. Additional information: Supplementary information: The online version contains supplementary material available at Correspondence and requests for materials should be addressed to Pamela Griffiths, [email protected] . References Poindexter BB, Feng R, Schmidt B, et al. 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Jan 2017;34(2):155-163. doi:10.1055/s-0036-1584897 Hansen TP, Noel-MacDonnell J, Kuckelman S, Norberg M, Truog W, Manimtim W. A multidisciplinary chronic lung disease team in a neonatal intensive care unit is associated with increased survival to discharge of infants with tracheostomy. J Perinatol . Apr 1 2021;doi:10.1038/s41372-021-00974-2 McKinney RL, Schmidhoefer JJ, Balasco AL, Machan JT, Hirway P, Keszler M. Severe bronchopulmonary dysplasia: outcomes before and after the implementation of an inpatient multidisciplinary team. J Perinatol . Mar 2021;41(3):544-550. doi:10.1038/s41372-020-00863-0 Shepherd EG, Knupp AM, Welty SE, Susey KM, Gardner WP, Gest AL. An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations. J Perinatol . Jan 2012;32(1):33-8. doi:10.1038/jp.2011.45 Jensen EA, Dysart K, Gantz MG, et al. The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. 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Extremely low birthweight neonates with protracted ventilation: mortality and 18-month neurodevelopmental outcomes. J Pediatr . Jun 2005;146(6):798-804. doi:10.1016/j.jpeds.2005.01.047 Overstreet DW, Jackson JC, van Belle G, Truog WE. Estimation of mortality risk in chronically ventilated infants with bronchopulmonary dysplasia. Pediatrics . Dec 1991;88(6):1153-60. Abman SH, Burchell MF, Schaffer MS, Rosenberg AA. Late sudden unexpected deaths in hospitalized infants with bronchopulmonary dysplasia. Am J Dis Child . Jul 1989;143(7):815-9. doi:10.1001/archpedi.1989.02150190065022 Kim HR, Jung YH, Kim BI, Kim SY, Choi CW. Differences in Comorbidities and Clinical Burden of Severe Bronchopulmonary Dysplasia Based on Disease Severity. Front Pediatr . 2021;9:664033. doi:10.3389/fped.2021.664033 Vyas-Read S, Logan JW, Cuna AC, et al. A comparison of newer classifications of bronchopulmonary dysplasia: findings from the Children's Hospitals Neonatal Consortium Severe BPD Group. J Perinatol . Jan 2022;42(1):58-64. doi:10.1038/s41372-021-01178-4 Murthy K, Savani RC, Lagatta JM, et al. Predicting death or tracheostomy placement in infants with severe bronchopulmonary dysplasia. J Perinatol . Jul 2014;34(7):543-8. doi:10.1038/jp.2014.35 Canning A, Fairhurst R, Chauhan M, Weir KA. Oral Feeding for Infants and Children Receiving Nasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula Respiratory Supports: A Survey of Practice. Dysphagia . Jun 2020;35(3):443-454. doi:10.1007/s00455-019-10047-4 Hanin M, Nuthakki S, Malkar MB, Jadcherla SR. Safety and Efficacy of Oral Feeding in Infants with BPD on Nasal CPAP. Dysphagia . Apr 2015;30(2):121-7. doi:10.1007/s00455-014-9586-x Joseph RA, Evitts P, Bayley EW, Tulenko C. Oral Feeding Outcome in Infants with a Tracheostomy. J Pediatr Nurs . Mar-Apr 2017;33:70-75. doi:10.1016/j.pedn.2016.12.012 Bamat NA, Kirpalani H, Feudtner C, et al. Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children's hospitals. J Perinatol . Sep 2019;39(9):1291-1299. doi:10.1038/s41372-019-0415-9 Ryan RM, Keller RL, Poindexter BB, et al. Respiratory Medications in Infants <29 Weeks during the First Year Postdischarge: The Prematurity and Respiratory Outcomes Program (PROP) Consortium. J Pediatr . May 2019;208:148-155 e3. doi:10.1016/j.jpeds.2018.12.009 Lewis T, Truog W, Nelin L, Napolitano N, McKinney RL. Pharmacoepidemiology of Drug Exposure in Intubated and Non-Intubated Preterm Infants With Severe Bronchopulmonary Dysplasia. Front Pharmacol . 2021;12:695270. doi:10.3389/fphar.2021.695270 Bassler D, Plavka R, Shinwell ES, et al. Early Inhaled Budesonide for the Prevention of Bronchopulmonary Dysplasia. N Engl J Med . Oct 15 2015;373(16):1497-506. doi:10.1056/NEJMoa1501917 Cristea AI, Ren CL, Amin R, et al. Outpatient Respiratory Management of Infants, Children, and Adolescents with Post-Prematurity Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med . Dec 15 2021;204(12):e115-e133. doi:10.1164/rccm.202110-2269ST Cristea AI, Carroll AE, Davis SD, Swigonski NL, Ackerman VL. Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home. Pediatrics . Sep 2013;132(3):e727-34. doi:10.1542/peds.2012-2990 Murthy K, Porta NFM, Lagatta JM, et al. Inter-center variation in death or tracheostomy placement in infants with severe bronchopulmonary dysplasia. J Perinatol . Jun 2017;37(6):723-727. doi:10.1038/jp.2016.277 Sammour I, Conlon SM, Bauer SE, Montgomery GS, Cristea AI, Rose RS. Adjusting ventilator settings to avoid air trapping in extremely premature infants reduces the need for tracheostomy and length of stay. Front Pediatr . 2022;10:1059081. doi:10.3389/fped.2022.1059081 McGrath-Morrow SA, Ryan T, Riekert K, Lefton-Greif MA, Eakin M, Collaco JM. The impact of bronchopulmonary dysplasia on caregiver health related quality of life during the first 2 years of life. Pediatr Pulmonol . Jun 2013;48(6):579-86. doi:10.1002/ppul.22687 Lagatta J, Harris M, Cusatis R, Malnory M, Dawson S, Konduri G. Identifying Barriers and Facilitators to Care for Infants with Bronchopulmonary Dysplasia After NICU Discharge: A Prospective Study of Parents and Clinical Stakeholders. Res Sq . Oct 9 2023;doi:10.21203/rs.3.rs-3377817/v1 Tables Table 1: Demographic and clinical characteristics stratified by BPD Grade Characteristic Overall N = 1,747 Jensen Grade 2 N = 1,237 Jensen Grade 3 N = 510 Maternal age N 1,661 1,187 474 Median (IQR) 29 (24, 33) 29 (24, 33) 29 (25, 34) Maternal Race Asian 52 / 1,747 (3.0%) 43 / 1,237 (3.5%) 9 / 510 (1.8%) Black or African American 565 / 1,747 (32.3%) 392 / 1,237 (31.7%) 173 / 510 (33.9%) White 929 / 1,747 (53.2%) 663 / 1,237 (53.6%) 266 / 510 (52.2%) Other 113 / 1,747 (6.5%) 75 / 1,237 (6.1%) 38 / 510 (7.5%) Unknown 88 / 1,747 (5.0%) 64 / 1,237 (5.2%) 24 / 510 (4.7%) Maternal Ethnicity Hispanic or Latino 197 / 1,747 (11.3%) 139 / 1,237 (11.2%) 58 / 510 (11.4%) Not Hispanic or Latino 1,402 / 1,747 (80.3%) 985 / 1,237 (79.6%) 417 / 510 (81.8%) Unknown 148 / 1,747 (8.5%) 113 / 1,237 (9.1%) 35 / 510 (6.9%) Prenatal Corticosteroids 1,376 / 1,603 (85.8%) 977 / 1,152 (84.8%) 399 / 451 (88.5%) Maternal Chorioamnionitis 232 / 1,724 (13.5%) 173 / 1,225 (14.1%) 59 / 499 (11.8%) Cesarean Delivery 1,285 / 1,747 (73.6%) 900 / 1,237 (72.8%) 385 / 510 (75.5%) Male sex 983 / 1,742 (56.4%) 687 / 1,233 (55.7%) 296 / 509 (58.2%) Obstetrical gestational age 25 (24, 27) 26 (24, 27) 25 (24, 26) Birth weight (g) 738 (600, 930) 762 (615, 955) 670 (563, 841) Fenton birth weight z-score N 1,739 1,231 508 Median (IQR) -0.2 (-1.0, 0.4) -0.2 (-0.9, 0.4) -0.5 (-1.3, 0.3) Birth length (cm) N 1,596 1,158 438 Median (IQR) 32 (30, 35) 32 (30, 35) 31 (29, 33) Fenton birth length z-score N 1,535 1,113 422 Median (IQR) -0.4 (-1.2, 0.2) -0.3 (-1.2, 0.3) -0.7 (-1.5, 0.2) Birth Head Circumference (cm) N 1,582 1,148 434 Median (IQR) 22.8 (21.0, 24.5) 23.0 (21.2, 24.9) 22.0 (21.0, 24.0) Fenton birth HC z-score N 1,525 1,106 419 Median (IQR) -0.5 (-1.2, 0.2) -0.4 (-1.2, 0.2) -0.5 (-1.4, 0.2) SGA 328 / 1,739 (18.9%) 198 / 1,231 (16.1%) 130 / 508 (25.6%) Intubated in Delivery Room 1,200 / 1,743 (68.8%) 793 / 1,234 (64.3%) 407 / 509 (80.0%) PMA at admission (weeks) 28 (25, 32) 28 (25, 31) 29 (25, 33) CA at admission to BPD center 10 (0, 42) 9 (0, 35) 15 (0, 59) SGA, small for gestational age; PMA, postmenstrual age; CA, chronologic age Table 2: Primary outcomes for the overall cohort, stratified by survival Characteristic Overall N = 1,747 Survivors 1 , N = 1,666 Deceased N = 81 p-value BPD Grade <0.001 2 Jensen Grade 2 1,237 / 1,747 (70.8%) 1,220 / 1,666 (73.2%) 17 / 81 (21.0%) Jensen Grade 3 510 / 1,747 (29.2%) 446 / 1,666 (26.8%) 64 / 81 (79.0%) Tracheostomy 250 / 1,747 (14.3%) 217 / 1,666 (13.0%) 33 / 81 (40.7%) <0.001 2 Gastrostomy tube 662 / 1,718 (38.5%) 639 / 1,652 (38.7%) 23 / 66 (34.8%) 0.5 2 Discharge weight z-score , n 1,719 1,640 79 0.2 3 Median (IQR) -0.7 (-1.5, 0.0) -0.7 (-1.4, 0.0) -1.2 (-2.4, 0.3) Discharge length z-score , n 1,678 1,608 70 <0.001 3 Median (IQR) -1.7 (-2.7, -0.8) -1.7 (-2.6, -0.8) -3.8 (-5.1, -2.6) Discharge head circumference z-score , n 1,063 1,028 35 Median (IQR) -0.8 (-1.5, -0.1) -0.8 (-1.5, -0.1) -1.3 (-2.5, 0.3) 0.3 3 PMA at hospital discharge (weeks), n 1,747 1,666 81 0.003 3 Median (IQR) 46 (42, 54) 46 (42, 54) 51 (43, 70) Hospital Discharge Age , n 1,747 1,666 81 0.004 3 Median (IQR) 153 (119, 209) 152 (119, 208) 185 (126, 308) Length of Stay, n 1,747 1,666 81 0.2 3 Median (IQR) 130 (94, 185) 130 (94, 183) 135 (91, 263) 1 Survivors include infants discharged home, to foster care, or to another care facility; 2 Pearson Chi-squared, 3 Wilcoxon rank sum Table 3: Respiratory support, medications, and enteral feeding at discharge or death Characteristic Overall N = 1,747 Survivors 1 N = 1,666 Deceased N = 81 Discharge Respiratory Support Room Air 464 / 1,747 (26.6%) 462 / 1,666 (27.7%) 2 / 81 (2.5%) LFNC 915 / 1,747 (52.4%) 915 / 1,666 (54.9%) 0 / 81 (0.0%) Non-invasive Positive Pressure 17 / 1,747 (1.0%) 16 / 1,666 (1.0%) 1 / 81 (1.2%) Invasive Positive Pressure 243 / 1,747 (13.9%) 169 / 1,666 (10.1%) 74 / 81 (91.4%) Trach Collar 37 / 1,747 (2.1%) 37 / 1,666 (2.2%) 0 / 81 (0.0%) Not recorded 71 / 1,747 (4.1%) 67 / 1,666 (4.0%) 4 / 81 (4.9%) Medications Pulmonary Vasodilators 85 / 1,622 (5.2%) 85 / 1,622 (5.2%) Systemic Corticosteroid 2 223 / 1,622 (13.7%) 223 / 1,622 (13.7%) Any Inhaled Medications 3 894 / 1,622 (55.1%) 894 / 1,622 (55.1%) Inhaled corticosteroids 820 / 1,622 (50.6%) 820 / 1,622 (50.6%) Beta agonist 740 / 1,622 (45.6%) 740 / 1,622 (45.6%) Diuretics 224 / 1,622 (13.8%) 224 / 1,622 (13.8%) Infant discharged on Full Enteral Nutrition (tube or oral feeding ) Yes 1,582 / 1,747 (90.6%) 1,566 / 1,666 (94.0%) No 133 / 1,747 (7.6%) 88 / 1,666 (5.3%) Unknown 32 / 1,747 (1.8%) 12 / 1,666 (0.7%) Infant discharged on PO feeds (full or partial oral feeding) None 482 / 1,747 (27.6%) 423 / 1,666 (25.4%) Some 404 / 1,747 (23.1%) 403 / 1,666 (24.2%) All 829 / 1,747 (47.5%) 829 / 1,666 (49.8%) Unknown 32 / 1,747 (1.8%) 11 / 1,666 (0.7%) 1 Survivors include infants discharged home, to foster care, or to another care facility 2 Defined by combining use of Dexamethasone, Hydrocortisone, Prednisolone, Prednisone 3 Any inhaled medication includes beta agonist, inhaled corticosteroids Additional Declarations There is NO conflict of interest to disclose. Supplementary Files SupplementalTables.docx Cite Share Download PDF Status: Under Review Version 1 posted Review # 2 received at journal 13 Mar, 2026 Reviewer # 2 agreed at journal 19 Feb, 2026 Reviewer # 1 agreed at journal 18 Feb, 2026 Reviewers invited by journal 17 Feb, 2026 Submission checks completed at journal 16 Feb, 2026 Editor assigned by journal 13 Feb, 2026 First submitted to journal 13 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8870533","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":593035029,"identity":"91cd5bd6-96cd-4658-a502-cb7f67168540","order_by":0,"name":"Pamela Griffiths","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0003-4775-2448","institution":"Phoenix Children's","correspondingAuthor":true,"prefix":"","firstName":"Pamela","middleName":"","lastName":"Griffiths","suffix":""},{"id":593035030,"identity":"6b08773b-172a-4beb-a442-518fe03b0c8d","order_by":1,"name":"Matthew Kielt","email":"","orcid":"https://orcid.org/0000-0002-4568-9070","institution":"Nationwide Children's Hospital, The Ohio State University College of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Matthew","middleName":"","lastName":"Kielt","suffix":""},{"id":593035031,"identity":"b22239f5-ee03-49c7-8261-2c9e8e0d51d7","order_by":2,"name":"Milenka Cuevas Guaman","email":"","orcid":"https://orcid.org/0000-0002-3835-5806","institution":"Texas Childrens Hospital, Baylor College of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Milenka","middleName":"Cuevas","lastName":"Guaman","suffix":""},{"id":593035032,"identity":"7a36c1fe-7332-417c-b99a-67b7ce24c26f","order_by":3,"name":"Jonathan Levin","email":"","orcid":"https://orcid.org/0000-0002-8422-791X","institution":"Boston Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jonathan","middleName":"","lastName":"Levin","suffix":""},{"id":593035033,"identity":"0556dd78-6853-429b-9935-897cf21e15fe","order_by":4,"name":"Sara Conroy","email":"","orcid":"https://orcid.org/0000-0001-9155-9456","institution":"The Ohio State University","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"","lastName":"Conroy","suffix":""},{"id":593035034,"identity":"be33f8e2-519c-404e-9a5b-e8fe32bad170","order_by":5,"name":"Steven Abman","email":"","orcid":"https://orcid.org/0000-0002-7292-2085","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Steven","middleName":"","lastName":"Abman","suffix":""},{"id":593035035,"identity":"bf88ea28-d1d6-4742-8857-0f04f34e7d8c","order_by":6,"name":"Leif Nelin","email":"","orcid":"https://orcid.org/0000-0002-3722-3035","institution":"Research Institute at Nationwide Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Leif","middleName":"","lastName":"Nelin","suffix":""}],"badges":[],"createdAt":"2026-02-13 10:20:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8870533/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8870533/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103504746,"identity":"35632e8a-8462-425f-b369-78453ddeb8d9","added_by":"auto","created_at":"2026-02-26 13:21:13","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":89942,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flow diagram\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8870533/v1/86b8f9c744a62bd7d9d99f64.png"},{"id":103177325,"identity":"c7005874-2006-415b-a804-010461adf658","added_by":"auto","created_at":"2026-02-22 16:48:55","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":49493,"visible":true,"origin":"","legend":"\u003cp\u003eRespiratory support at registry time points among survivors (n = 1,666)\u003c/p\u003e\n\u003cp\u003eN=1,666 at each time point. Specific counts are in Supplementary Table 1.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8870533/v1/5625591b152a940813528187.png"},{"id":103512041,"identity":"38b0d85b-a760-4eef-af3a-123790a1d1b1","added_by":"auto","created_at":"2026-02-26 14:12:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1945946,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8870533/v1/0d55d877-2a6c-44ac-b6e3-38910643522e.pdf"},{"id":103177327,"identity":"83a47b19-b710-4ada-a9a4-0fe07996abd5","added_by":"auto","created_at":"2026-02-22 16:48:55","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":75189,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalTables.docx","url":"https://assets-eu.researchsquare.com/files/rs-8870533/v1/fba37e07544079c2c312f0c8.docx"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e conflict of interest to disclose.","formattedTitle":"Characteristics and Outcomes of Infants with Severe Bronchopulmonary Dysplasia Admitted to BPD Collaborative Centers","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBronchopulmonary dysplasia (BPD) is the most common chronic respiratory morbidity affecting preterm infants and typically follows treatments with oxygen and ventilator support for acute respiratory distress after birth.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Those with the most severe forms of BPD, particularly infants who experience a protracted course of invasive ventilation, often have extensive co-morbidities and chronic medical needs. In addition to care from neonatologists and pulmonologists, these infants often require care from subspecialists for management of pulmonary hypertension (PH), airway abnormalities, retinopathy of prematurity, nutrition, metabolic bone disease, and growth failure. Achieving optimal developmental progress is challenging and requires an integrated approach that includes goal-directed developmental therapies and adequate respiratory support to promote patient comfort and an interactive state.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e To address the complex medical and psychosocial needs of infants with severe BPD, interdisciplinary care programs have been developed that integrate pediatric sub-specialists, physical and occupational therapists, speech pathologists, dietitians, pharmacists, respiratory therapists, developmental specialists, and social workers.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Single-center studies of interdisciplinary BPD programs suggest that infants enrolled in these programs experience high rates of survival, short-term improvements in catch-up growth, low rates of hospital readmission, and favorable neurodevelopmental outcomes.\u003csup\u003e\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Whether the favorable outcomes observed in single-center interdisciplinary BPD program studies are generalizable across centers remains unknown.\u003c/p\u003e \u003cp\u003eIn 2012, the BPD Collaborative was formed to leverage the experience of centers with interdisciplinary BPD care programs to address knowledge gaps in the evidence-based care of infants with severe BPD. The BPD Collaborative advances interdisciplinary collaboration through data sharing between centers in the form of a patient registry that characterizes patient demographics, management, and late outcomes for both inpatient and outpatient care. The objective of this study is to leverage the BPD collaborative registry to characterize clinical features and outcomes of infants with grade 2\u0026ndash;3 BPD to identify areas for future investigation aimed at improving sBPD outcomes.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population\u003c/h2\u003e \u003cp\u003eThe BPD Collaborative is comprised of academic medical centers with interdisciplinary BPD programs who contribute to a retrospective registry of de-identified patients born\u0026thinsp;\u0026lt;\u0026thinsp;32 weeks gestation with grades 2 and 3 BPD per Neonatal Research Network (NRN) \u0026ldquo;Jensen\u0026rdquo; criteria\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. The registry includes demographic data and clinical data for specific time points: 7 and 28 days of age, 36-, 44-, and 50-weeks postmenstrual age (PMA), and at death or discharge. Infants are enrolled locally at varying PMA based on admission, ranging from birth in hospitals who have obstetrical services to beyond term-corrected PMA due to severe established BPD. Eligible study subjects included infants enrolled in the BPD Collaborative inpatient registry between January 1, 2015 \u0026ndash; September 30, 2024. Infants for whom finalized demographic data were available were eligible for this study. Additional inclusion criteria included 1) BPD grade 2 or 3, 2) gestational age (GA)\u0026thinsp;\u0026lt;\u0026thinsp;32 weeks, 3) complete disposition data, and 4) age at admission\u0026thinsp;\u0026lt;\u0026thinsp;1000 days. At the time of analysis, 18 BPD Collaborative centers with patients meeting inclusion criteria were represented in the study: Arkansas Children\u0026rsquo;s Hospital, Boston Children\u0026rsquo;s Hospital, C.S Mott Children\u0026rsquo;s Hospital of Michigan, Children\u0026rsquo;s Hospital of Philadelphia, Children\u0026rsquo;s Mercy Kansas City, Children\u0026rsquo;s Hospital Los Angeles, Riley Children\u0026rsquo;s Hospital at IU Health, Joe DiMaggio Children\u0026rsquo;s Hospital, Le Bonheur Children\u0026rsquo;s Hospital, Nationwide Children\u0026rsquo;s Hospital, Penn State Health Children\u0026rsquo;s Hospital, Phoenix Children\u0026rsquo;s, Saitama Medical Center (Japan), Texas Children\u0026rsquo;s Hospital, The Woman\u0026rsquo;s Hospital of Texas, University of Massachusetts Memorial Medical Center, Vanderbilt University Medical Center, and Women and Infants Hospital of Rhode Island. Each contributing hospital obtained Institutional Review Board oversight and approval from their respective institutions to participate in the BPD Collaborative registry. This is a descriptive report of the inpatient registry; an outpatient registry is also maintained but is not described here.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eClinical Characteristics\u003c/h3\u003e\n\u003cp\u003eClinical characteristics collected from study subjects included: maternal demographics, neonatal characteristics at birth, and respiratory support and medication exposure at 7 and 28 days after birth, 36-, 44-, and 50-weeks PMA, and at discharge. Weight was recorded at birth, 36 weeks PMA, and discharge, whereas length was only available at birth and discharge. Patients were classified as grade 3 BPD if they were treated with invasive mechanical ventilation at 36 weeks PMA. Invasive ventilation includes the following modalities: positive end-expiratory pressure with pressure support, conventional ventilation, high frequency ventilation, and invasive neurally adjusted ventilatory assist (NAVA). Non-invasive positive pressure ventilation includes nasal continuous positive airway pressure (CPAP), nasal intermittent positive pressure ventilation (NIPPV), synchronized intermittent positive airway pressure (SiPAP), bilevel positive airway pressure (BiPAP), and non-invasive-NAVA. Demographic data were stratified by BPD classification (Grade 2 or 3).\u003c/p\u003e\n\u003ch3\u003eStudy Outcomes\u003c/h3\u003e\n\u003cp\u003ePrimary study outcomes were stratified by survivors and non-survivors and included: BPD Grade at 36 weeks PMA, gastrostomy, tracheostomy, length of stay (LOS), PMA, and Z-scores for weight and length at the time of discharge or death. Fenton growth curves were used for Z-score calculations for patients\u0026thinsp;\u0026lt;\u0026thinsp;50 weeks PMA at discharge.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e World Health Organization (WHO) growth curves were used for Z-score calculations for patients\u0026thinsp;\u0026ge;\u0026thinsp;50 weeks PMA at discharge.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eStandard descriptive statistics for the cohort are presented as median with interquartile range (IQR) for continuous data and number (n) with percentage (%) for categorical data. Survival was compared using Wilcoxon rank sum for continuous variables or Pearson\u0026rsquo;s chi-squared test for categorical variables. Following best statistical practice and STROBE reporting guidelines, p-values are not presented in the descriptive tables.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e Missing data are noted in tables and analysis included only infants with available data. Statistical analysis was performed using R version 4.1.2 (R Foundation for Statistical Computing, Vienna, Austria).\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStudy Cohort\u003c/h2\u003e \u003cp\u003eOverall, 2512 infants had finalized demographic data. Of these, 1747 had BPD grade 2 or 3 and discharge data and were included in the analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Data availability for clinical measures at specified timepoints varied from 638 patients at 50 weeks PMA to 1747 patients at 36 weeks PMA.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePatient characteristics\u003c/h3\u003e\n\u003cp\u003eDemographics and early neonatal characteristics are reported for the overall cohort and stratified by BPD grade (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Across the overall cohort, mothers had a median age of 29 years and the following demographic distribution: 53.2% White, 32.3% Black/African American, 3.0% Asian, and 6.5% Other, with 11.3% of Hispanic or Latino ethnicity. American Indian or Alaskan Native and Native Hawaiian or Other Pacific Islander races were combined into the \u0026ldquo;Other\u0026rdquo; classification. Most mothers (85.8%) received at least one dose of antenatal corticosteroids, and 13.5% had a diagnosis of chorioamnionitis. Males represented 56.4% of infants in the cohort. The median birth gestation was 25 (24, 27) weeks, median birth weight was 738 (600, 930) g, and median birth length was 32 (30, 35) cm, with 18.9% of infants born small for gestational age (SGA). For the overall cohort, median age at time of admission to a BPD center was 10 (0, 42) days with a corresponding median PMA of 28 (25, 32) weeks (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). At 36 weeks PMA, 29.1% of the cohort was classified as grade 3 BPD.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic and clinical characteristics stratified by BPD Grade\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;1,747\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eJensen Grade 2\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;1,237\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJensen Grade 3\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;510\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternal age\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e474\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (24, 33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (24, 33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (25, 34)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMaternal Race\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 / 1,747 (3.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 / 1,237 (3.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 / 510 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack or African American\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e565 / 1,747 (32.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e392 / 1,237 (31.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e173 / 510 (33.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e929 / 1,747 (53.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e663 / 1,237 (53.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e266 / 510 (52.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 / 1,747 (6.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75 / 1,237 (6.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38 / 510 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88 / 1,747 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 / 1,237 (5.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 / 510 (4.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMaternal Ethnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHispanic or Latino\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e197 / 1,747 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139 / 1,237 (11.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58 / 510 (11.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot Hispanic or Latino\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,402 / 1,747 (80.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e985 / 1,237 (79.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e417 / 510 (81.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148 / 1,747 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113 / 1,237 (9.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 / 510 (6.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrenatal Corticosteroids\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,376 / 1,603 (85.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e977 / 1,152 (84.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e399 / 451 (88.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMaternal Chorioamnionitis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e232 / 1,724 (13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e173 / 1,225 (14.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 / 499 (11.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCesarean Delivery\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,285 / 1,747 (73.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e900 / 1,237 (72.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e385 / 510 (75.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e983 / 1,742 (56.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e687 / 1,233 (55.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e296 / 509 (58.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eObstetrical gestational age\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (24, 27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (24, 27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (24, 26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBirth weight (g)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e738 (600, 930)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e762 (615, 955)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e670 (563, 841)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFenton birth weight z-score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,739\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.2 (-1.0, 0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.2 (-0.9, 0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.5 (-1.3, 0.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBirth length (cm)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e438\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (30, 35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (30, 35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (29, 33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFenton birth length z-score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e422\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.4 (-1.2, 0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.3 (-1.2, 0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.7 (-1.5, 0.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBirth Head Circumference (cm)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,582\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e434\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.8 (21.0, 24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.0 (21.2, 24.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.0 (21.0, 24.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFenton birth HC z-score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e419\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.5 (-1.2, 0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.4 (-1.2, 0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.5 (-1.4, 0.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSGA\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e328 / 1,739 (18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e198 / 1,231 (16.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e130 / 508 (25.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntubated in Delivery Room\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,200 / 1,743 (68.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e793 / 1,234 (64.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e407 / 509 (80.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePMA at admission (weeks)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (25, 32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (25, 31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (25, 33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCA at admission to BPD center\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (0, 42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (0, 35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (0, 59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eSGA, small for gestational age; PMA, postmenstrual age; CA, chronologic age\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003ePrimary study outcomes: Conditions at discharge or death\u003c/h3\u003e\n\u003cp\u003eIn-hospital outcomes were stratified by disposition (discharge to home/foster care/care facility, or death) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). We observed a survival rate of 95.4% during the data collection window. Compared to survivors at discharge, a greater proportion of non-survivors were designated Grade 3 BPD (79.0% vs 26.8%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and had lower length z-scores at death (-3.8 vs \u0026minus;\u0026thinsp;1.7, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A greater proportion of non-survivors underwent tracheostomy (40.7% vs 13.0%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while similar proportions underwent gastrostomy (34.8% and 38.7% for non-survivors and survivors, respectively, p\u0026thinsp;=\u0026thinsp;0.5). The median LOS for the overall cohort was 130 (94, 185) days; the median chronologic age at death or discharge was 153 (119, 209) days, with a corresponding PMA of 46 (42, 54) weeks. Compared to survivors, non-survivors had a similar LOS (p\u0026thinsp;=\u0026thinsp;0.2) and were older at disposition, with a chronologic age of 185 (126, 308) days (p\u0026thinsp;=\u0026thinsp;0.004) and corresponding PMA of 51 (43, 70) weeks at time of death (p\u0026thinsp;=\u0026thinsp;0.003). Discharge disposition was to home or foster care for 1,554 (89%) infants and to a care facility for 112 (6.4%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrimary outcomes for the overall cohort, stratified by survival\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOverall\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;1,747\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSurvivors\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e,\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;1,666\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeceased\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;81\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBPD Grade\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJensen Grade 2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,237 / 1,747 (70.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,220 / 1,666 (73.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17 / 81 (21.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJensen Grade 3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e510 / 1,747 (29.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e446 / 1,666 (26.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e64 / 81 (79.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTracheostomy\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e250 / 1,747 (14.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e217 / 1,666 (13.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33 / 81 (40.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGastrostomy tube\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e662 / 1,718 (38.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e639 / 1,652 (38.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23 / 66 (34.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.5\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDischarge weight z-score\u003c/b\u003e, n\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,640\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.2\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.7 (-1.5, 0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.7 (-1.4, 0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.2 (-2.4, 0.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDischarge length z-score\u003c/b\u003e, n\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,678\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,608\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-1.7 (-2.7, -0.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.7 (-2.6, -0.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-3.8 (-5.1, -2.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDischarge head circumference z-score\u003c/b\u003e, n\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,063\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,028\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.8 (-1.5, -0.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.8 (-1.5, -0.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.3 (-2.5, 0.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.3\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePMA at hospital discharge\u003c/b\u003e (weeks), n\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,747\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,666\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46 (42, 54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46 (42, 54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51 (43, 70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHospital Discharge Age\u003c/b\u003e, n\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,747\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,666\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.004\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e153 (119, 209)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e152 (119, 208)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e185 (126, 308)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLength of Stay\u003c/b\u003e, n\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,747\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,666\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.2\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e130 (94, 185)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e130 (94, 183)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e135 (91, 263)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e1\u003c/sup\u003e Survivors include infants discharged home, to foster care, or to another care facility; \u003csup\u003e2\u003c/sup\u003e Pearson Chi-squared, \u003csup\u003e3\u003c/sup\u003e Wilcoxon rank sum\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eN\u0026thinsp;=\u0026thinsp;1,666 at each time point. Specific counts are in Supplementary Table\u0026nbsp;1.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRespiratory support, medications, and enteral feeding at discharge or death\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;1,747\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSurvivors\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;1,666\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDeceased\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;81\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarge Respiratory Support\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoom Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e464 / 1,747 (26.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e462 / 1,666 (27.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 / 81 (2.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLFNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e915 / 1,747 (52.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e915 / 1,666 (54.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 / 81 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-invasive Positive Pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 / 1,747 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 / 1,666 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 / 81 (1.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvasive Positive Pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e243 / 1,747 (13.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169 / 1,666 (10.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74 / 81 (91.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrach Collar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 / 1,747 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 / 1,666 (2.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 / 81 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot recorded\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71 / 1,747 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67 / 1,666 (4.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 / 81 (4.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulmonary Vasodilators\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85 / 1,622 (5.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85 / 1,622 (5.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSystemic Corticosteroid\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e223 / 1,622 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e223 / 1,622 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAny Inhaled Medications\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e894 / 1,622 (55.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e894 / 1,622 (55.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInhaled corticosteroids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e820 / 1,622 (50.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e820 / 1,622 (50.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeta agonist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e740 / 1,622 (45.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e740 / 1,622 (45.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiuretics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e224 / 1,622 (13.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e224 / 1,622 (13.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInfant discharged on Full Enteral Nutrition (tube or oral feeding\u003c/b\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,582 / 1,747 (90.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,566 / 1,666 (94.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e133 / 1,747 (7.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88 / 1,666 (5.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 / 1,747 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 / 1,666 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInfant discharged on PO feeds (full or partial oral feeding)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e482 / 1,747 (27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e423 / 1,666 (25.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e404 / 1,747 (23.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e403 / 1,666 (24.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e829 / 1,747 (47.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e829 / 1,666 (49.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 / 1,747 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 / 1,666 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e1\u003c/sup\u003e Survivors include infants discharged home, to foster care, or to another care facility\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e2\u003c/sup\u003e Defined by combining use of Dexamethasone, Hydrocortisone, Prednisolone, Prednisone\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e3\u003c/sup\u003e Any inhaled medication includes beta agonist, inhaled corticosteroids\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSecondary outcomes: Respiratory, pharmacologic, and nutritional support\u003c/h2\u003e \u003cp\u003eA descriptive summary of respiratory support for survivors during their hospital stay is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (Supp Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The percentage of infants receiving invasive respiratory support declined over the measured registry time points from 51% and 52% at 7- and 28-days following birth, respectively, to 29% at 36 weeks PMA and 25% (257/1041) at 44 weeks PMA, but was higher with 32% (184/576) at 50 weeks PMA for those who remained admitted at each time point (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). At disposition, 69.4% (1212/1747) were receiving respiratory support, most by low flow nasal cannula (52.4%), followed by room air (RA) in 26.6%, invasive positive pressure ventilation (IPPV) in 13.9%, trach collar (TC) in 2.1%, and NIPPV in 1.0% (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eMedication use at discharge among survivors included inhaled corticosteroids in 50.6%, inhaled beta agonists in 45.6%, diuretics in 13.8%, systemic corticosteroids in 13.7%, and pulmonary vasodilators in 5.2%. Among all survivors at discharge, 49.8% were taking full oral feedings, 24.2% partial oral feeding, with 49% receiving supplemental tube feeding. Among those discharged to home or foster care, 52.9% took all oral feeds, whereas only 6.3% of those discharged to a care facility were taking all feeds by PO route (Supplemental Table\u0026nbsp;2).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we describe the characteristics of a large contemporary cohort of 1747 infants with sBPD enrolled in 18 interdisciplinary BPD programs. While many NICUs will only treat a handful of these patients per year, this cohort is unique in that it provides insight into a large population of sBPD patients managed by highly interactive teams of clinicians and staff at various BPD Collaborative sites. In this high-acuity population, including 29% with grade 3 BPD, we observed a high rate of survival (95.4%). When compared to historical cohorts of infants with sBPD from the 1980\u0026rsquo;s-90\u0026rsquo;s with reported in-hospital survival rates of approximately 75%,\u003csup\u003e13\u0026ndash;15\u003c/sup\u003e our study and others\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e demonstrate that in-hospital survival rates for infants with established sBPD have increased over time. The majority were discharged on nasal cannula or room air at a median PMA of 46 weeks and LOS of 130 days, outcomes most consider favorable. Despite this, these patients nonetheless remain at risk of ongoing respiratory and nutritional morbidity as evidenced by ongoing need for supplemental oxygen, tube feeding, and medication use at the time of hospital discharge observed in this cohort.\u003c/p\u003e \u003cp\u003eThe respiratory support needs in this cohort were significant, with 29%, 25%, and 32% of infants still hospitalized and receiving invasive positive pressure support at 36-, 44-, and 50-weeks PMA, respectively, consistent with greater disease severity in this unique cohort. In addition to the high percentage of patients discharged on respiratory support (68.2%, 1137/1666), supplemental feeds via nasogastric tube or gastrostomy further contribute to complexity of care. While infants with sBPD are known to have oral feeding difficulties, little data exists to describe oral feeding practices in infants with sBPD, especially among those with ongoing need for positive pressure respiratory support.\u003csup\u003e\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Our study found that only 49.8% of infants in the BPD Collaborative cohort took all feeds orally and 24.2% took partial volume by oral route by the time of discharge, leaving 50.2% dependent on either full or supplemental tube feeding, including those who received a gastrostomy tube. These findings highlight the need for prospective multicenter studies to assess the role of feeding routes on respiratory, growth, and developmental achievements, with emphasis on identifying infants with sBPD who are at highest risk for gastrostomy placement.\u003c/p\u003e \u003cp\u003eAlthough infants with sBPD are exposed to multiple medications during their NICU hospitalization and through discharge, the evidence for routine administration of many of these medications is lacking, and their use across centers varies.\u003csup\u003e\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e For survivors at discharge, we observed 50.6% use of inhaled corticosteroids, 45.6% beta agonists, 13.8% diuretics, 13.7% systemic steroids, and 5.2% pulmonary vasodilators. The relatively high frequency of use of inhaled medications in our cohort in the face of a paucity of evidence supporting its use also raises questions about factors contributing to prescribing practices. Investigation into patient characteristics, timing and indication for initiation, dose, and clinical response are needed to refine usage.\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eWhile representing only a small percentage (6.4%, 112/1747) of our cohort, those discharged to a care facility represent an especially fragile group. The majority were supported with invasive ventilation (66.1%) and had greater usage of all reported medications (pulmonary vasodilators, systemic steroids, inhaled corticosteroids, bronchodilators, and diuretics). This group likely represents both infants transferred to lower acuity transitional care units and those discharged to medical group homes, including those with ongoing educational needs and non-respiratory medical or social complexity. Data on clinical characteristics and outcomes of this population are lacking. One single-center study reported discharge to a chronic care facility for 11 of 102 subjects with sBPD requiring tracheostomy and long-term ventilation,\u003csup\u003e27\u003c/sup\u003e of which 4 were deceased by the time of publication. Further understanding of this cohort would allow for improved anticipatory guidance and inform future studies on optimizing transition of care for these patients.\u003c/p\u003e \u003cp\u003eAs expected, non-survivors were characterized by a greater severity of illness with a significantly greater proportion having grade 3 BPD and receiving tracheostomy. They also experienced worse linear growth than their surviving counterparts. Length of stay was like that of survivors, but final disposition occurred at older chronologic and postmenstrual ages, owing to their older age at admission to BPD Collaborative Centers. Murthy, et al\u003csup\u003e18,28\u003c/sup\u003e have previously described that those infants with sBPD who are referred later to Children\u0026rsquo;s Hospitals Neonatal Consortium (CNHC) centers experienced greater likelihood of death or tracheostomy. However, this finding was limited by referral bias, in which case infants with more severe disease are more likely to be referred to participating NICUs. The current cohort is also likely affected by referral bias, limiting the ability to draw conclusions related to timing of admission to a BPD center and outcomes. However, Sammour, et al\u003csup\u003e29\u003c/sup\u003e have reported lower rates of tracheostomy and LOS following implementation of routine consultation and evaluation by an interdisciplinary BPD program starting as early as 28 days of life and utilizing an individualized approach to adjusting respiratory support to avoid air trapping. This suggests that earlier recognition of changing lung physiology and adjustment of the ventilatory strategy may alter the disease course. Research focused on less mature infants with evolving BPD may ultimately have a profound impact on longer-term respiratory and developmental outcomes.\u003c/p\u003e \u003cp\u003eA growing number of observational studies describe improved outcomes resulting from implementation of interdisciplinary BPD programs. Among the most complex and ill infants that require tracheostomy, improved survival has been reported following implementation of interdisciplinary teams.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e Beyond survival, improved neurodevelopmental outcomes, growth, length of stay, outpatient visits, and readmissions have all been described following adoption of interdisciplinary care teams.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e Unfortunately, evidence-based care practices that reduce morbidity and improve long-term outcomes in this growing and vulnerable population are wanting, owing to a paucity of research documenting individuals living with established severe BPD. Our results highlight the need for evidence-based strategies that not only improve survival but optimize long term respiratory outcomes and identify indications for prolonged respiratory support, nutritional support, and respiratory medications in the NICU and after discharge.\u003c/p\u003e \u003cp\u003eWhile we report favorable infant outcomes, we must also consider the impact on families and caregivers who are continuing to care for medically fragile children following discharge. It is known that families of children with chronic diseases are more likely to experience healthcare-related quality of life impairment and that this risk is higher in those with more frequent respiratory symptoms and acute care utilization.\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e Many families may continue to struggle with difficulty navigating healthcare systems and accessing available community resources.\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eStrengths of this study include its large size, unique study population, and rich source of multicenter data from the BPD Collaborative. Additionally, we provide a longitudinal perspective on patterns of support received. A limitation of the current study is the descriptive, retrospective design, which lends the findings to generating hypotheses and informing future works. Additionally, generalizability may be limited as it is unclear if this is a representative population of grades 2 and 3 BPD patients. It is also likely that variability in demographics, practices, and outcomes exist between centers within this cohort, but this was not explicitly explored in this manuscript. The data presented in this descriptive study provides a perspective on the current state of care for infants with sBPD. Our results call attention to the ongoing need for further investigation in areas such as optimal medication usage, oral feeding practices, and ideal timing of respiratory support transitions. In addition, we note that many infants with sBPD are affected by complex medical needs at discharge. Efforts to improve discharge processes, family education, and health advocacy should remain a priority. We anticipate that the next ten years will yield exponential growth of our understanding of sBPD that can be leveraged to improve treatment and outcomes for affected infants.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur multi-center BPD Collaborative registry study demonstrates that infants with established sBPD have high in-hospital survival rates, but a high burden of respiratory and nutritional support and medication use at birth hospitalization discharge. Extensive characterization of the clinical course of infants with severe BPD, especially related to late outcomes, may better inform clinical trial design for interventional strategies. Future studies are needed to advance knowledge and evidence-based practice for optimal care for infants with sBPD.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePSG: none; MJK none; MCG none; JCL none; SC none; SHA none; LDN none.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePSG conceptualized the manuscript. MJK conducted the analyses. \u0026nbsp;SC provided statistical support. MJK, JCL, and MCG interpreted the results of the analysis. \u0026nbsp;All authors contributed data. \u0026nbsp;SHA, LDN provided supervision, resources, and oversight. PSG wrote the initial draft of the manuscript; all authors reviewed the manuscript and approved its final version for submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA de-identified dataset is available upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Victoria Bernaud and Stephanie Villa of the Phoenix Children’s Scientific Writing Core for their critical review and editing of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdditional information:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSupplementary information: The online version contains supplementary material available at\u003cbr\u003e\u0026nbsp;Correspondence and requests for materials should be addressed to Pamela Griffiths, [email protected].\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePoindexter BB, Feng R, Schmidt B, et al. Comparisons and Limitations of Current Definitions of Bronchopulmonary Dysplasia for the Prematurity and Respiratory Outcomes Program. \u003cem\u003eAnn Am Thorac Soc\u003c/em\u003e. Dec 2015;12(12):1822-30. doi:10.1513/AnnalsATS.201504-218OC\u003c/li\u003e\n\u003cli\u003eLogan JW, Lynch SK, Curtiss J, Shepherd EG. Clinical phenotypes and management concepts for severe, established bronchopulmonary dysplasia. \u003cem\u003ePaediatr Respir Rev\u003c/em\u003e. Aug 2019;31:58-63. doi:10.1016/j.prrv.2018.10.004\u003c/li\u003e\n\u003cli\u003eCristea AI, Tracy MC, Bauer SE, et al. Approaches to Interdisciplinary Care for Infants with Severe Bronchopulmonary Dysplasia: A Survey of the Bronchopulmonary Dysplasia Collaborative. \u003cem\u003eAm J Perinatol\u003c/em\u003e. Dec 7 2022;doi:10.1055/s-0042-1755589\u003c/li\u003e\n\u003cli\u003eGien J, Kinsella J, Thrasher J, Grenolds A, Abman SH, Baker CD. Retrospective Analysis of an Interdisciplinary Ventilator Care Program Intervention on Survival of Infants with Ventilator-Dependent Bronchopulmonary Dysplasia. \u003cem\u003eAm J Perinatol\u003c/em\u003e. Jan 2017;34(2):155-163. doi:10.1055/s-0036-1584897\u003c/li\u003e\n\u003cli\u003eHansen TP, Noel-MacDonnell J, Kuckelman S, Norberg M, Truog W, Manimtim W. A multidisciplinary chronic lung disease team in a neonatal intensive care unit is associated with increased survival to discharge of infants with tracheostomy. \u003cem\u003eJ Perinatol\u003c/em\u003e. Apr 1 2021;doi:10.1038/s41372-021-00974-2\u003c/li\u003e\n\u003cli\u003eMcKinney RL, Schmidhoefer JJ, Balasco AL, Machan JT, Hirway P, Keszler M. Severe bronchopulmonary dysplasia: outcomes before and after the implementation of an inpatient multidisciplinary team. \u003cem\u003eJ Perinatol\u003c/em\u003e. Mar 2021;41(3):544-550. doi:10.1038/s41372-020-00863-0\u003c/li\u003e\n\u003cli\u003eShepherd EG, Knupp AM, Welty SE, Susey KM, Gardner WP, Gest AL. An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations. \u003cem\u003eJ Perinatol\u003c/em\u003e. Jan 2012;32(1):33-8. doi:10.1038/jp.2011.45\u003c/li\u003e\n\u003cli\u003eJensen EA, Dysart K, Gantz MG, et al. The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. An Evidence-based Approach. \u003cem\u003eAm J Respir Crit Care Med\u003c/em\u003e. Sep 15 2019;200(6):751-759. doi:10.1164/rccm.201812-2348OC\u003c/li\u003e\n\u003cli\u003eFenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. \u003cem\u003eBMC Pediatr\u003c/em\u003e. Apr 20 2013;13:59. doi:10.1186/1471-2431-13-59\u003c/li\u003e\n\u003cli\u003eD F. whoanthro: Calculate various z-scores, percentiles, etc. from the WHO growth charts. R package version 0.1.1 ed. 2024. https://cran.r-project.org/web/packages/anthro/anthro.pdf\u003c/li\u003e\n\u003cli\u003evon Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. \u003cem\u003eJ Clin Epidemiol\u003c/em\u003e. Apr 2008;61(4):344-9. doi:10.1016/j.jclinepi.2007.11.008\u003c/li\u003e\n\u003cli\u003eR Core Team (2023). \u003cem\u003eR: A Language and Environment for Statistical Computing.\u003c/em\u003e . R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/.\u003c/li\u003e\n\u003cli\u003eWalsh MC, Morris BH, Wrage LA, et al. Extremely low birthweight neonates with protracted ventilation: mortality and 18-month neurodevelopmental outcomes. \u003cem\u003eJ Pediatr\u003c/em\u003e. Jun 2005;146(6):798-804. doi:10.1016/j.jpeds.2005.01.047\u003c/li\u003e\n\u003cli\u003eOverstreet DW, Jackson JC, van Belle G, Truog WE. Estimation of mortality risk in chronically ventilated infants with bronchopulmonary dysplasia. \u003cem\u003ePediatrics\u003c/em\u003e. Dec 1991;88(6):1153-60. \u003c/li\u003e\n\u003cli\u003eAbman SH, Burchell MF, Schaffer MS, Rosenberg AA. Late sudden unexpected deaths in hospitalized infants with bronchopulmonary dysplasia. \u003cem\u003eAm J Dis Child\u003c/em\u003e. Jul 1989;143(7):815-9. doi:10.1001/archpedi.1989.02150190065022\u003c/li\u003e\n\u003cli\u003eKim HR, Jung YH, Kim BI, Kim SY, Choi CW. Differences in Comorbidities and Clinical Burden of Severe Bronchopulmonary Dysplasia Based on Disease Severity. \u003cem\u003eFront Pediatr\u003c/em\u003e. 2021;9:664033. doi:10.3389/fped.2021.664033\u003c/li\u003e\n\u003cli\u003eVyas-Read S, Logan JW, Cuna AC, et al. A comparison of newer classifications of bronchopulmonary dysplasia: findings from the Children\u0026apos;s Hospitals Neonatal Consortium Severe BPD Group. \u003cem\u003eJ Perinatol\u003c/em\u003e. Jan 2022;42(1):58-64. doi:10.1038/s41372-021-01178-4\u003c/li\u003e\n\u003cli\u003eMurthy K, Savani RC, Lagatta JM, et al. Predicting death or tracheostomy placement in infants with severe bronchopulmonary dysplasia. \u003cem\u003eJ Perinatol\u003c/em\u003e. Jul 2014;34(7):543-8. doi:10.1038/jp.2014.35\u003c/li\u003e\n\u003cli\u003eCanning A, Fairhurst R, Chauhan M, Weir KA. Oral Feeding for Infants and Children Receiving Nasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula Respiratory Supports: A Survey of Practice. \u003cem\u003eDysphagia\u003c/em\u003e. Jun 2020;35(3):443-454. doi:10.1007/s00455-019-10047-4\u003c/li\u003e\n\u003cli\u003eHanin M, Nuthakki S, Malkar MB, Jadcherla SR. Safety and Efficacy of Oral Feeding in Infants with BPD on Nasal CPAP. \u003cem\u003eDysphagia\u003c/em\u003e. Apr 2015;30(2):121-7. doi:10.1007/s00455-014-9586-x\u003c/li\u003e\n\u003cli\u003eJoseph RA, Evitts P, Bayley EW, Tulenko C. Oral Feeding Outcome in Infants with a Tracheostomy. \u003cem\u003eJ Pediatr Nurs\u003c/em\u003e. Mar-Apr 2017;33:70-75. doi:10.1016/j.pedn.2016.12.012\u003c/li\u003e\n\u003cli\u003eBamat NA, Kirpalani H, Feudtner C, et al. Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children\u0026apos;s hospitals. \u003cem\u003eJ Perinatol\u003c/em\u003e. Sep 2019;39(9):1291-1299. doi:10.1038/s41372-019-0415-9\u003c/li\u003e\n\u003cli\u003eRyan RM, Keller RL, Poindexter BB, et al. Respiratory Medications in Infants \u0026lt;29 Weeks during the First Year Postdischarge: The Prematurity and Respiratory Outcomes Program (PROP) Consortium. \u003cem\u003eJ Pediatr\u003c/em\u003e. May 2019;208:148-155 e3. doi:10.1016/j.jpeds.2018.12.009\u003c/li\u003e\n\u003cli\u003eLewis T, Truog W, Nelin L, Napolitano N, McKinney RL. Pharmacoepidemiology of Drug Exposure in Intubated and Non-Intubated Preterm Infants With Severe Bronchopulmonary Dysplasia. \u003cem\u003eFront Pharmacol\u003c/em\u003e. 2021;12:695270. doi:10.3389/fphar.2021.695270\u003c/li\u003e\n\u003cli\u003eBassler D, Plavka R, Shinwell ES, et al. Early Inhaled Budesonide for the Prevention of Bronchopulmonary Dysplasia. \u003cem\u003eN Engl J Med\u003c/em\u003e. Oct 15 2015;373(16):1497-506. doi:10.1056/NEJMoa1501917\u003c/li\u003e\n\u003cli\u003eCristea AI, Ren CL, Amin R, et al. Outpatient Respiratory Management of Infants, Children, and Adolescents with Post-Prematurity Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline. \u003cem\u003eAm J Respir Crit Care Med\u003c/em\u003e. Dec 15 2021;204(12):e115-e133. doi:10.1164/rccm.202110-2269ST\u003c/li\u003e\n\u003cli\u003eCristea AI, Carroll AE, Davis SD, Swigonski NL, Ackerman VL. Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home. \u003cem\u003ePediatrics\u003c/em\u003e. Sep 2013;132(3):e727-34. doi:10.1542/peds.2012-2990\u003c/li\u003e\n\u003cli\u003eMurthy K, Porta NFM, Lagatta JM, et al. Inter-center variation in death or tracheostomy placement in infants with severe bronchopulmonary dysplasia. \u003cem\u003eJ Perinatol\u003c/em\u003e. Jun 2017;37(6):723-727. doi:10.1038/jp.2016.277\u003c/li\u003e\n\u003cli\u003eSammour I, Conlon SM, Bauer SE, Montgomery GS, Cristea AI, Rose RS. Adjusting ventilator settings to avoid air trapping in extremely premature infants reduces the need for tracheostomy and length of stay. \u003cem\u003eFront Pediatr\u003c/em\u003e. 2022;10:1059081. doi:10.3389/fped.2022.1059081\u003c/li\u003e\n\u003cli\u003eMcGrath-Morrow SA, Ryan T, Riekert K, Lefton-Greif MA, Eakin M, Collaco JM. The impact of bronchopulmonary dysplasia on caregiver health related quality of life during the first 2 years of life. \u003cem\u003ePediatr Pulmonol\u003c/em\u003e. Jun 2013;48(6):579-86. doi:10.1002/ppul.22687\u003c/li\u003e\n\u003cli\u003eLagatta J, Harris M, Cusatis R, Malnory M, Dawson S, Konduri G. Identifying Barriers and Facilitators to Care for Infants with Bronchopulmonary Dysplasia After NICU Discharge: A Prospective Study of Parents and Clinical Stakeholders. \u003cem\u003eRes Sq\u003c/em\u003e. Oct 9 2023;doi:10.21203/rs.3.rs-3377817/v1\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1: Demographic and clinical characteristics stratified by BPD Grade\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"672\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 1,747\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJensen Grade 2\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 1,237\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJensen Grade 3\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 510\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,661\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e1,187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e474\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e29 (24, 33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e29 (24, 33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e29 (25, 34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal\u003c/strong\u003e \u003cstrong\u003eRace\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eAsian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e52 / 1,747 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e43 / 1,237 (3.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e9 / 510 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eBlack or African American\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e565 / 1,747 (32.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e392 / 1,237 (31.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e173 / 510 (33.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e929 / 1,747 (53.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e663 / 1,237 (53.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e266 / 510 (52.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e113 / 1,747 (6.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e75 / 1,237 (6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e38 / 510 (7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e88 / 1,747 (5.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e64 / 1,237 (5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e24 / 510 (4.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal Ethnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eHispanic or Latino\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e197 / 1,747 (11.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e139 / 1,237 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e58 / 510 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eNot Hispanic or Latino\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,402 / 1,747 (80.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e985 / 1,237 (79.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e417 / 510 (81.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e148 / 1,747 (8.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e113 / 1,237 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e35 / 510 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrenatal Corticosteroids\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,376 / 1,603 (85.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e977 / 1,152 (84.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e399 / 451 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal Chorioamnionitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e232 / 1,724 (13.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e173 / 1,225 (14.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e59 / 499 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCesarean Delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,285 / 1,747 (73.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e900 / 1,237 (72.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e385 / 510 (75.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale sex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e983 / 1,742 (56.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e687 / 1,233 (55.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e296 / 509 (58.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eObstetrical gestational age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e25 (24, 27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e26 (24, 27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e25 (24, 26)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth weight (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e738 (600, 930)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e762 (615, 955)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e670 (563, 841)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFenton birth weight z-score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,739\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e1,231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e508\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e-0.2 (-1.0, 0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e-0.2 (-0.9, 0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e-0.5 (-1.3, 0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth length (cm)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,596\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e1,158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e438\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e32 (30, 35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e32 (30, 35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e31 (29, 33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFenton birth length z-score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e1,113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e422\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e-0.4 (-1.2, 0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e-0.3 (-1.2, 0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e-0.7 (-1.5, 0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirth Head Circumference (cm)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,582\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e1,148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e434\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e22.8 (21.0, 24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e23.0 (21.2, 24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e22.0 (21.0, 24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFenton birth HC z-score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,525\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e1,106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e419\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e-0.5 (-1.2, 0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e-0.4 (-1.2, 0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e-0.5 (-1.4, 0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSGA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e328 / 1,739 (18.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e198 / 1,231 (16.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e130 / 508 (25.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntubated in Delivery Room\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e1,200 / 1,743 (68.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e793 / 1,234 (64.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e407 / 509 (80.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePMA at admission (weeks)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e28 (25, 32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e28 (25, 31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e29 (25, 33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 30.312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCA at admission to BPD center\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 23.9227%;\"\u003e\n \u003cp\u003e10 (0, 42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e9 (0, 35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 22.8826%;\"\u003e\n \u003cp\u003e15 (0, 59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSGA, small for gestational age; PMA, postmenstrual age; CA, chronologic age\u003c/p\u003e\n\u003cp\u003eTable 2: Primary outcomes for the overall cohort, stratified by survival\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"648\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 1,747\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvivors\u003csup\u003e1\u003c/sup\u003e,\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 1,666\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDeceased\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 81\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBPD Grade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eJensen Grade 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,237 / 1,747 (70.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,220 / 1,666 (73.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e17 / 81 (21.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eJensen Grade 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e510 / 1,747 (29.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e446 / 1,666 (26.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e64 / 81 (79.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTracheostomy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e250 / 1,747 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e217 / 1,666 (13.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e33 / 81 (40.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGastrostomy tube\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e662 / 1,718 (38.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e639 / 1,652 (38.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e23 / 66 (34.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e0.5\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDischarge weight z-score\u003c/strong\u003e, n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e0.2\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e-0.7 (-1.5, 0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e-0.7 (-1.4, 0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e-1.2 (-2.4, 0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDischarge length z-score\u003c/strong\u003e, n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,608\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e-1.7 (-2.7, -0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e-1.7 (-2.6, -0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e-3.8 (-5.1, -2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDischarge head circumference z-score\u003c/strong\u003e, n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e-0.8 (-1.5, -0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e-0.8 (-1.5, -0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e-1.3 (-2.5, 0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e0.3\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePMA at hospital discharge\u003c/strong\u003e (weeks), n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,747\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,666\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e0.003\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e46 (42, 54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e46 (42, 54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e51 (43, 70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHospital Discharge Age\u003c/strong\u003e, n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,747\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,666\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e0.004\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e153 (119, 209)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e152 (119, 208)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e185 (126, 308)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLength of Stay,\u003c/strong\u003e n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e1,747\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e1,666\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e0.2\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.7778%;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3704%;\"\u003e\n \u003cp\u003e130 (94, 185)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.2963%;\"\u003e\n \u003cp\u003e130 (94, 183)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.4444%;\"\u003e\n \u003cp\u003e135 (91, 263)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 11.1111%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003e Survivors include infants discharged home, to foster care, or to another care facility; \u003csup\u003e2\u003c/sup\u003e Pearson Chi-squared, \u003csup\u003e3\u003c/sup\u003e Wilcoxon rank sum\u003c/p\u003e\n\u003cp\u003eTable 3: Respiratory support, medications, and enteral feeding at discharge or death\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 1,747\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvivors\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N = 1,666\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDeceased\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN = 81\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDischarge Respiratory Support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eRoom Air\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e464 / 1,747 (26.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e462 / 1,666 (27.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e2 / 81 (2.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eLFNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e915 / 1,747 (52.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e915 / 1,666 (54.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e0 / 81 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eNon-invasive Positive Pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e17 / 1,747 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e16 / 1,666 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e1 / 81 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eInvasive Positive Pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e243 / 1,747 (13.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e169 / 1,666 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e74 / 81 (91.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eTrach Collar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e37 / 1,747 (2.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e37 / 1,666 (2.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e0 / 81 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eNot recorded\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e71 / 1,747 (4.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e67 / 1,666 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e4 / 81 (4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003ePulmonary Vasodilators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e85 / 1,622 (5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e85 / 1,622 (5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eSystemic Corticosteroid\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e223 / 1,622 (13.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e223 / 1,622 (13.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eAny Inhaled Medications\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e894 / 1,622 (55.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e894 / 1,622 (55.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eInhaled corticosteroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e820 / 1,622 (50.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e820 / 1,622 (50.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eBeta agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e740 / 1,622 (45.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e740 / 1,622 (45.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eDiuretics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e224 / 1,622 (13.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e224 / 1,622 (13.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfant discharged on Full Enteral Nutrition (tube or oral feeding\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e1,582 / 1,747 (90.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e1,566 / 1,666 (94.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e133 / 1,747 (7.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e88 / 1,666 (5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e32 / 1,747 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e12 / 1,666 (0.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfant discharged on PO feeds (full or partial oral feeding)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e482 / 1,747 (27.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e423 / 1,666 (25.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eSome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e404 / 1,747 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e403 / 1,666 (24.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eAll\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e829 / 1,747 (47.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e829 / 1,666 (49.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 35.9935%;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e32 / 1,747 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.8241%;\"\u003e\n \u003cp\u003e11 / 1,666 (0.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.3583%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003e Survivors include infants discharged home, to foster care, or to another care facility\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003e Defined by combining use of Dexamethasone, Hydrocortisone, Prednisolone, Prednisone\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003e Any inhaled medication includes beta agonist, inhaled corticosteroids\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-perinatology","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"jp","sideBox":"Learn more about [Journal of Perinatology](http://www.nature.com/jp/)","snPcode":"41372","submissionUrl":"https://mts-jper.nature.com/cgi-bin/main.plex","title":"Journal of Perinatology","twitterHandle":"@jperinatology","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8870533/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8870533/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo describe key clinical features and outcomes for infants with grade 2-3 bronchopulmonary dysplasia (sBPD) enrolled in interdisciplinary BPD programs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn observational multi-center retrospective study of infants hospitalized in BPD Collaborative centers with grade 2-3 BPD from 2015-2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf 1747 infants, 29.2% had grade 3 BPD. Survival was high (95.4%) but accompanied by high need for respiratory support (68.2%), technology dependence (13.0% tracheostomy, 38.7% gastrostomy, 49.6% supplemental feeds), and respiratory medications at discharge (55% on inhaled medication). Median length of stay (LOS) and postmenstrual age (PMA) at discharge were 130 (94, 183) days and 47 (42, 54) weeks.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDespite high in-hospital survival of infants with sBPD who were enrolled in interdisciplinary BPD programs, most require high levels of support at discharge. Future studies are needed to identify targeted interventions that reduce the burden of care for infants with sBPD at the time of birth hospitalization discharge.\u003c/p\u003e","manuscriptTitle":"Characteristics and Outcomes of Infants with Severe Bronchopulmonary Dysplasia Admitted to BPD Collaborative Centers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-22 16:48:50","doi":"10.21203/rs.3.rs-8870533/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"This content is not available.","date":"2026-03-13T15:36:00+00:00","index":2,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2026-02-19T14:56:05+00:00","index":2,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2026-02-18T05:25:25+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewersInvited","content":"","date":"2026-02-18T02:10:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-16T17:37:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-13T10:16:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Perinatology","date":"2026-02-13T10:16:04+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-perinatology","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"jp","sideBox":"Learn more about [Journal of Perinatology](http://www.nature.com/jp/)","snPcode":"41372","submissionUrl":"https://mts-jper.nature.com/cgi-bin/main.plex","title":"Journal of Perinatology","twitterHandle":"@jperinatology","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"bff518ca-92c9-49a2-8cdc-4610fb9a61dd","owner":[],"postedDate":"February 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":63101742,"name":"Health sciences/Health care/Paediatrics"},{"id":63101743,"name":"Health sciences/Medical research/Epidemiology"}],"tags":[],"updatedAt":"2026-02-22T16:48:51+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-22 16:48:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8870533","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8870533","identity":"rs-8870533","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}