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Cognitive performance at school age of very low birth weight infants with bronchopulmonary dysplasia
C A Hughes1, L A O'Gorman, Y Shyr
1Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, USA.
Insights
Bronchopulmonary dysplasia (BPD) significantly impacts school-aged children's cognitive abilities. Children with BPD showed poorer performance in IQ, academic grades, and specific cognitive tests compared to peers without BPD.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Neonatal Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Long-term neurodevelopmental outcomes in infants with BPD require further investigation.
- Cognitive deficits may persist into school age for survivors of severe neonatal respiratory conditions.
Purpose of the Study:
- To investigate the long-term effects of bronchopulmonary dysplasia (BPD) on cognitive performance in school-aged children.
- To compare cognitive outcomes between very low birth weight (VLBW) infants with and without BPD, and term infants.
- To identify specific cognitive domains affected by a history of BPD.
Main Methods:
- Prospective cohort study involving three groups of children aged 8-10 years.
- Group 1: VLBW infants without BPD (n=311).
- Group 2: VLBW infants with BPD (n=95).
- Group 3: Term infants without BPD (n=188).
- Regression analysis was used to assess BPD's effect on cognitive measures, controlling for confounders.
Main Results:
- Children with BPD (Group 2) exhibited the poorest performance across all cognitive measures compared to term infants (Group 3).
- Significant differences were observed in Full Scale IQ, Performance IQ, reading, and math performance (p=.0001).
- VLBW infants with BPD also showed poorer Verbal IQ and visual-motor integration compared to term infants, but not significantly different from VLBW infants without BPD.
Conclusions:
- Bronchopulmonary dysplasia (BPD) is associated with adverse cognitive outcomes at school age.
- VLBW infants with a history of BPD demonstrate significant deficits in cognitive functioning.
- Early lung injury in preterm infants may have lasting neurodevelopmental consequences impacting academic and intellectual abilities.
Abstract:
The hypothesis was that bronchopulmonary dysplasia (BPD) adversely affects cognitive performance at school age. This prospective cohort study examined three groups of children at 8 to 10 years of age. Group 1 (n = 311) consisted of very low birth weight (VLBW) infants without BPD and Group 2 (n = 95) consisted of VLBW infants with BPD. Group 3 (n = 188) consisted of term infants without BPD. Regression analysis determined the effect of BPD on eight performance measures while controlling for possible confounding variables. Children in Group 3 had the best performance and children in Group 2 had the poorest performance on all measures. These differences were significant (p = .0001) for the Full Scale IQ, Performance IQ, and reading and math grades and ages. Children in Groups 3 and 1 performed better than children in Group 2 for the Verbal IQ (p = .0001) and the Developmental Test of Visual-Motor Integration (p = .0012), but for these two measures there was no significant difference between children in Groups 3 and 1. Thus, poorer performance was found in VLBW infants with a history of BPD.