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Bronchopulmonary Dysplasia Symptoms, Causes and Risk Factors

The symptoms of BPD vary depending on its severity. Several risk factors make the development of BPD more likely but do not automatically lead to BPD.

What are the Symptoms of Bronchopulmonary Dysplasia?

The most common symptoms of bronchopulmonary dysplasia are:

  • Rapid breathing
  • Labored breathing (drawing in of the lower chest while breathing in)
  • Wheezing (a soft whistling sound as the baby breathes out)
  • Bluish discoloration of the skin around the lips and nails due to low oxygen in the blood
  • Poor growth
  • Repeated lung infections that may require hospitalization

What Causes Bronchopulmonary Dysplasia?

The cause of BPD is related to lifesaving oxygen and mechanical ventilation. While a relatively high amount of inhaled oxygen over several days may be necessary to support life, it may also cause damage to the alveoli.  This is sometimes made worse when the ventilator blows air into the lung, overstretching the alveoli.  Less well understood, inflammation can damage the inside lining of the airways, the alveoli and even the blood vessels around them. These effects are particularly damaging on the premature lung, and BPD is considered to be primarily a complication of prematurity.

What Are Risk Factors?

There are several conditions that do not cause but make the development of BPD more likely (risk factors) such as the following:

  • Degree of prematurity: The less developed the lungs, the more they are likely to be damanged and result in BPD.  BPD is rare in infants born after 32 weeks of pregnancy.
  • Prolonged mechanical ventilation: Mechanical ventilation stretches the alveoli. When overstretched, and for longer periods of time, that may damage them.
  • High concentrations of oxygen: The higher the concentration of oxygen and longer duration it is given, the higher the possibility of developing BPD. In general, concentrations of less than 60% oxygen are considered to be relatively safe.
  • Male gender: Male infants are more likely to be born prematurely and to develop BPD.
  • Maternal conditions: Maternal smoking or use of illicit drugs, maternal malnutrition, and infections in the mother during the pregnancy may affect the normal growth of the fetus, and may lead to premature labor, development of respiratory distress syndrome, and eventually to BPD.
  • Other risk factors:
    • Patent ductus arterosus. The ductus arteriosus is a blood vessel connects the right and left side of the heart that closes shortly after birth.  This vessel is more likely to remain open in premature infants causing lung damage when too much blood flows into the lungs.
    • Intrauterine growth retardation (IUGR): Different conditions may affect the growth of the fetus during the pregnancy and may also lead to premature labor. Relatively undeveloped lungs are more likely to develop BPD.

When to See Your Doctor

As infants with BPD usually had oxygen and mechanical ventilation, they are often in the hospital when diagnosed.  Regardless, you should contact your pediatrician if:

  • Your infant/child is breathing much faster than the usual (e.g., a general rule is about 10 to 20 breaths higher than the usual rate).
  • The breathing is labored (pulling in of the skin between the ribs, below the chest or at the bottom of the neck just above the chest).
  • There is bluish discoloration around mouth or lips.
  • If there are frequent alarms of the apnea monitor and/or pulse oximeter.

    This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.

    Page Last Updated: May 9, 2018

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