Bronchopulmonary Dysplasia (BPD) is a serious lung condition that affects premature babies, especially those born at a very low birth weights. One in 10 Australian babies is born premature, and up to 60 per cent of these develop BPD. If BPD takes hold in a newborn, there is no cure, and this condition can cause multiple severe life-long health complications.
What is BPD?
BPD is an inflammatory lung disease that mainly affects
- Premature babies born before 32 weeks of pregnancy
- Infant weighing less than 2000 grams at birth
- In some cases, full-term babies who had infections like pneumonia before or soon after birth.
Understanding the term
Bronchopulmonary: Refers to the airways and lungs .
- Airways (bronchial tubes) carry oxygen to the lungs (pulmonary)
- Tiny air sacs (alveoli) in the lungs allow oxygen to enter the bloodstream and remove carbon dioxide.
Dysplasia : Means abnormal changes to cell structures.
Other names for BPD
- Chronic lung disease of premature babies
- Chronic lung disease of infancy
- Neonatal chronic lung disease
- Respiratory insufficiency.
What causes BPD?
BPD is not present at birth. The condition develops when premature infants with underdeveloped lungs need breathing assistance. While life-saving, these interventions can lead to inflammation and scarring of the lungs.
How breathing support can lead to BPD
Premature babies often need mechanical ventilators to help them breathe. These machines
- Move air into underdeveloped lungs that can’t breath on their own.
- Deliver high oxygen levels than normal air to maintain the baby’s blood oxygen.
Potential risks
- Fragile, premature lungs can be easily irritated
- Pressure from the ventilator may overstretch tiny air sacs (alveoli)
- High oxygen levels can contribute to inflammation and lung damage
Balancing care
- Doctors and nurses carefully control oxygen flow and levels
- Ventilator support is used only when necessary to minimise risks
Who is at risk of BPD?
The risk of developing BPD increases with the degree of prematurity. Babies at higher risk include those who are
- Born more than 10 weeks early
- Weigh less than 2000 grams at birth
- Experience breathing difficulties at birth
- Affected by an infection before or shortly after birth.
Risk factors at a glance
- Extreme prematurity
- Very low birth weight
- Respiratory distress at birth
- Early infections
If your baby has any of these risk factors, discuss BPD prevention and management strategies with your neonatologist or paediatrician.
How is BPD treated?
Currently, there is no specific medication to cure or prevent BPD. Treatment focuses on supporting a baby’s breathing while allowing their lungs to heal and grow.
Main treatment goals
- Support breathing and provide oxygen
- Limit further lung damage
- Allow time for lung healing and growth
Balancing treatment
- While ventilators and extra oxygen are often not necessary, they can potentially harm delicate lungs
- Doctors aim to reduce ventilator use as soon as safely possible
Additional treatments: supportive care and medications may be used to address BPD-related issues to
- Improve air flow through the lungs
- Reduce excess fluid
- Control infections
- Decrease swelling
- Enhance blood flow
What are the long-term complications of BPD?
BPD can range from mild to severe. While most babies with BPD heal over time, some may face ongoing challenges.
Recovery timeline
- Most babies with BPD gradually heal after two to four months of assisted ventilation in the hospital
- Some recover close to normal lung function
- Others may experience long-term effects
Potential long-term complications
- Breathing problems like asthma, sleep apnoea
- Increased sensitivity to respiratory infections eg; influenza, colds
- Growth and development delays, especially in the first two years
- Neurological issues with the brain or central nervous system.
In severe cases
While medical advances have greatly improved outcomes for babies with BPD, in rare severe cases some infants may not survive despite months of intensive care.
Outcome of very-low-birthweight infants by Gestational Age (GA)
Figure | Klinger. Risk factors for BPD among VLBW infants. Am J Obstet Gynecol 2013.
Symptoms and diagnosis of BPD
Recognising BPD symptom: babies with BPD may show signs of respiratory distress, including
- Shortness of breath
- Fast or difficult breathing
- Wheezing
- Flaring nostrils
- Grunting
- Pauses in breathing
- Chest retractions (skin pulling in between ribs or under ribcage)
- Bluish skin colour (due to low oxygen levels)
How is BPD disgnosed? Doctors consider several factors when diagnosing BPD
- Breathing difficulties
- Prematurity
- History of infections
- Need for mechanical ventilation
- Oxygen exposure
Key diagnostic criteria
- BPD is typically diagnosed when a newborn needs breathing support for longer than 28 days
Additional tests
- Chest X-rays: To examine lung appearance
- Blood tests: To check oxygen levels and other indicators
Bronchopulmonary dysplasia (BPD) research at Hudson Institute
Hudson Institute scientists and clinician-scientists are at the forefront in developing new strategies to prevent and treat BPD in premature infants.
Our scientists are investigating existing inflammatory drugs, already approved for use in children, as potential preventative treatments for BPD. There is also have a clinical trail underway for a groundbreaking therapy using cells from human placentas to repair damaged lungs in premature babies .
These research efforts offer hope for reducing the impact of BPD on premature infants and their families, potentially improving outcomes and reducing healthcare costs.
Bronchopulmonary dysplasia (BPD) research projects underway
New anti-inflammatory approaches for BPD
Preventative treatment. Severe BPD causes considerable suffering for premature infants and their families and contributes substantially to health care costs. Knowing that inflammation is one of the key drivers of BPD, Professor Marcel Nold (Neonatologist and clinician scientist at Monash Newborn) and Associate Professor Claudia Nold are investigating existing anti-inflammatory medications, approved for use in children, that could be used as a preventative treatment to protect babies from developing BPD.
Team | Professor Marcel Nold, Professor Claudia Nold, Dr Ina Rudloff, Dr Christine Bui
Long term outcomes of amnion cell therapy for BPD in premature babies
New treatment. A world-first therapy using cells from the human placenta to repair the damaged lungs of premature babies is now in a Phase I trial. This follows a successful safety trial, completed in 2018, that was the culmination of 10 years research by Professor Rebecca Lim. The current Phase I dose-escalation trial will determine the optimum dosage and frequency of cells given to the baby to get the best long-term consequences. This is a multi-centre trial with Royal Women’s Hospital and Monash Newborn.
Team | Associate Professor Rebecca Lim, Associate Professor Atul Malhotra, Professor Euan Wallace AM, Dr Dandan Zhu
Bronchopulmonary dysplasia (BPD) news
Bronchopulmonary dysplasia (BPD) collaborators
Support for people with bronchopulmonary dysplasia (BPD)
Our scientists cannot provide medical advice.
If you would like to find out more information about bronchopulmonary dysplasia, please visit
Keep up-to-date with our latest discoveries
