Ureaplasma colonization increases the risk of moderate-severe bronchopulmonary dysplasia despite postnatal treatment in newborns: a retrospective study based on the latest diagnostic criteria for bronchopulmonary dysplasia.

Objective: This study aimed to investigate the correlation of Ureaplasma and azithromycin with bronchopulmonary dysplasia (BPD) in premature infants.

Methods: This study included infants who tested positive for Ureaplasma in their respiratory tract and were treated with azithromycin, categorizing them into the study group. A control group was composed of infants who tested negative for Ureaplasma during the same specified period. The primary outcome included the incidence and severity of BPD.

Results: A total of 260 infants were included in our study. There was no significant difference in the overall incidence of BPD between the two groups (32.3 % vs. 23.1 %, P = 0.096). However, the study group had a higher proportion of moderate-severe BPD (18.5 % vs. 7.7 %, P = 0.010) and maternal prenatal azithromycin (50.8 % vs. 36.2 %, P = 0.017) compared to the control group. Multivariate analysis indicated that Ureaplasma colonization (OR, 2.781; 95 % CI, 1.101-7.024; P = 0.030) was an independent risk factor, while maternal prenatal azithromycin treatment (OR, 0.343; 95 % CI, 0.137-0.856; P = 0.022) was an independent protective factor for the development of moderate-severe BPD.

Conclusion: There is a significant correlation between Ureaplasma and the development of moderate-severe BPD in preterm infants. Prenatal azithromycin treatment in mothers may reduce the incidence of moderate-severe BPD, but postnatal treatment in infants may not have the same effect.