Peer-reviewed article
Chronic Lung Disease: A Study Based on the National Database of Specified Chronic Pediatric Diseases of Japan.
Namba F ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed data from Japan's national registry of children with chronic lung disease (CLD), primarily bronchopulmonary dysplasia. Among 1,737 registered children, 47% were extremely preterm infants and 24% were born at term, with term infants showing neurological and chromosomal disorders as common underlying conditions. The research found that extremely preterm infants requiring mechanical ventilation at 36 weeks after birth were more likely to remain in the chronic disease support program. The findings show that CLD in Japan affects a diverse population with different underlying causes depending on birth status.
Key points
- 1,737 children with CLD were registered in the national database; 47% were extremely preterm and 24% were term infants
- Among term infants with CLD, neurological disorders (43%) and chromosomal abnormalities (19%) were the most common underlying conditions
- Extremely preterm infants requiring invasive mechanical ventilation at 36 weeks' postmenstrual age were 3.16 times more likely to remain in chronic disease support
- Marked regional variation existed in the distribution of gestational ages across Japan
- The proportion of extremely preterm infants decreased with increasing age while term infant proportion increased in the registry
Limitations
This is a descriptive registry study with no control group, so it cannot determine causal relationships or evaluate the effectiveness of treatments. The study describes characteristics of registered children but cannot assess outcomes of different management strategies or compare children with CLD who are not registered.
Abstract
Background Chronic lung disease (CLD), commonly recognized as bronchopulmonary dysplasia and primarily associated with prematurity and low birth weight, is designated as a specified chronic pediatric disease in Japan. However, the characteristics of children registered in the National Database of Specified Chronic Pediatric Diseases have not been fully elucidated. Methods With approval from the Ethics Committee of Saitama Medical Center, Saitama Medical University, and the Third-Party Data Provision Office for Patients with Intractable Diseases, we analyzed data from Medical Certificates of Specific Chronic Pediatric Diseases for patients with CLD registered between January 2015 and March 2023. Results A total of 1737 patients with CLD were identified. Extremely preterm infants and term infants accounted for 47% and 24% of cases, respectively, with marked regional variation in gestational age distribution. Among 410 registered term infants, neurological disorders (43%) and chromosomal abnormalities (19%) were the most common underlying conditions. With increasing age, the proportion of extremely preterm infants decreased, whereas that of term infants increased. In a subgroup analysis of 805 extremely preterm infants, invasive mechanical ventilation at 36 weeks' postmenstrual age was independently associated with persistent registration within the chronic disease support program (odds ratio 3.16, 95% CI 1.81-5.52; p < 0.001). Conclusions This nationwide registry study demonstrates that registry-defined CLD in Japan represents a heterogeneous population, including a substantial number of term infants with diverse comorbidities. Among extremely preterm infants, the need for invasive respiratory support at 36 weeks' postmenstrual age was associated with persistent registration within the chronic disease support program, underscoring the importance of optimizing long-term management strategies.