Risk factors for bronchopulmonary dysplasia among preterm infants born before thirty-two weeks of gestation in Palestinian private hospitals

BACKGROUND Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease among premature infants, with long-term consequences for respiratory health, neurodevelopment, and overall growth. AIM To identify the major risk factors for BPD among preterm infants born before thirty-two weeks of gestation in private hospitals in the North West Bank, Palestine. METHODS A quantitative, retrospective cohort study was conducted in tertiary private hospitals equipped with neonatal intensive care units in the North West Bank. The study population included all premature infants born at < 32 weeks gestation, with a total sample size of 119 cases. Data were collected using a structured, self-developed tool comprising five sections: Demographic data, maternal history, birth and neonatal history, respiratory support and interventions, and infection/complications. Statistical analysis was performed using SPSS version 26, applying descriptive statistics, means, n (%) and inferential statistics, including the χ 2 test, to examine associations between maternal, neonatal, and clinical variables and the occurrence of BPD. RESULTS The mean birth weight of the infants was 1257.45 g. Most infants (88.2%) were born between 28-32 weeks of gestation, and 65.5% were male. Significant associations were found between BPD and maternal preeclampsia (P = 0.045) as well as patent ductus arteriosus (PDA). Common maternal conditions included preeclampsia (44.5%) and eclampsia (47.9%), while prevalent neonatal complications included PDA (58.5%), retinopathy of prematurity (31%), and sepsis (60.5%). All infants received mechanical ventilation (MV) and were administered surfactant. Notably, 75.6% required immediate intubation, reflecting severe respiratory distress. CONCLUSION This study identified low birth weight, gestational age, prolonged MV, and oxygen exposure as significant risk factors for BPD. Additional contributors included sepsis and intrauterine growth restriction. The findings underscore the importance of early detection, optimized respiratory management, and improved prenatal and neonatal care strategies to reduce the incidence and severity of BPD in preterm infants.