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

doi:10.5409/wjcp.v15.i2.117297

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Jun 9, 2026 (publication date) through May 16, 2026

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Pediatr. Jun 9, 2026; 15(2): 117297
Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.117297

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

Maram Z Algharabeh, Mu'taz M Dreidi, Najwa M Subuh, Omar H Almahmoud

Maram Z Algharabeh, Faculty of Graduate Studies, Master Program in Nursing Neonate, Arab American University, Ramallah 240, Palestine

Mu'taz M Dreidi, Omar H Almahmoud, Department of Nursing, Pharmacy, Nursing and Health Professions College, Birzeit University, Ramallah 14, Palestine

Najwa M Subuh, Department of Nursing, Arab American University, Ramallah 240, Palestine

Author contributions: Algharabeh MZ and Almahmoud OH conceptualized and designed the study; Dreidi MM and Subuh NM revised and modified the manuscript. All authors reviewed and approved the final manuscript.

AI contribution statement: AI-assisted tools were used only for language polishing, grammar correction, and improving clarity and readability. No part of the scientific content of the Main Text, including the Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion, was generated by AI. No AI tool was used for data analysis, statistical analysis, generation of results, or scientific interpretation. No AI tool participated in the design of the study or the interpretation of its findings. No images, figures, or illustrations in the manuscript were generated by AI. All authors have reviewed the final manuscript carefully and take full responsibility for the accuracy, integrity, and scientific content of the work.

Institutional review board statement: Ethical approval for this retrospective study was obtained from the Arab American University Institutional Review Board, approval No. R-2024/A/123/N.

Informed consent statement: As the study involved a retrospective review of existing medical records with no direct contact with patients and no identifiable personal information collected, the requirement for informed consent was formally waived by the Institutional Review Board in accordance with the national regulations governing human subjects research in Palestine.

Conflict-of-interest statement: The authors declare no competing interests.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at oalmahmoud@birzeit.edu.

Corresponding author: Omar H Almahmoud, Assistant Professor, Department of Nursing, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Ramallah 14, Palestine. oalmahmoud@birzeit.edu

Received: December 4, 2025
Revised: January 24, 2026
Accepted: February 11, 2026
Published online: June 9, 2026
Processing time: 160 Days and 21.7 Hours

Abstract

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 χ² 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.

Keywords: Bronchopulmonary dysplasia; Preterm infants; Risk factors; Neonatal intensive care unit; Mechanical ventilation; Oxygen therapy

Core Tip: This retrospective study highlights key clinical determinants of bronchopulmonary dysplasia (BPD) in very preterm infants born before thirty-two weeks of gestation in Palestinian private hospitals. Low birth weight, younger gestational age, prolonged mechanical ventilation, and extended oxygen exposure were identified as the strongest predictors of BPD. Sepsis was also a significant contributing factor. Early identification of high-risk infants and optimization of respiratory support strategies may reduce the burden of BPD and improve outcomes in this vulnerable population.