Bronchopulmonary dysplasia and chronic neonatal lung disease

Overview & Definition

Bronchopulmonary dysplasia (BPD) is the most common serious complication of extreme prematurity, affecting up to 40 percent of infants born before 28 weeks' gestation. The condition was first described by Northway in 1967 in oxygen-exposed, mechanically ventilated preterm infants, but the modern "new BPD" reflects arrested lung development rather than adult-style fibrotic injury ^[1].

The modern definition requires supplemental oxygen or respiratory support at 36 weeks' postmenstrual age (PMA), validated by the NIH consensus definition in a landmark multicentre study ^[2]. This standardised classification replaced older criteria that relied on oxygen dependency at 28 days of life and has become the universal benchmark for severity grading.

BPD sits at the intersection of neonatology, respiratory medicine, and developmental biology. The preterm lung is still in the canalicular-to-saccular stage when the infant is born, making it exquisitely vulnerable to the very interventions that sustain life — oxygen, positive pressure ventilation, and caloric restriction ^[10].

References11ShowHide

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11. [11]Askie LM, Darlow BA, Finer N, et al Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants Cochrane Database Syst Rev, 2017.PMID 28398697