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Severe bronchopulmonary dysplasia increases risk for later neurological and motor sequelae in preterm survivors
A Majnemer1, P Riley, M Shevell
1School of Physical and Occupational Therapy, Department of Pediatrics, Montreal Children's Hospital, McGill University, Quebec, Canada. Annette@physocc.lan.mcgill.ca
Insights
Children with severe bronchopulmonary dysplasia (BPD) requiring home oxygen face higher risks of neurological and motor deficits. Early recognition and intervention for these neuromotor impairments are crucial for maximizing their potential.
Area of Science:
- Pediatric Pulmonology
- Neurodevelopmental Pediatrics
- Neonatology
Background:
- Severe chronic lung disease in preterm infants, such as bronchopulmonary dysplasia (BPD), is linked to developmental risks.
- Hypoxic episodes associated with BPD may negatively impact neurodevelopment.
- Long-term outcomes for children with severe BPD require further investigation.
Purpose of the Study:
- To assess the risk of neurological and motor deficits at school age in children with severe BPD who required home oxygen therapy.
- To compare neuromotor outcomes between preterm children with and without a history of severe BPD.
- To identify factors associated with neuromotor sequelae in this population.
Main Methods:
- A cohort of 27 school-aged children with severe BPD (requiring home oxygen) was compared to 27 matched preterm controls.
- Standardized neuromotor outcome measures were used to evaluate neurological and motor function.
- Pair-matched comparisons and regression analyses were employed to analyze the data.
Main Results:
- The BPD group exhibited a significantly higher prevalence of neurological abnormalities (71% vs. 19%), including subtle signs, cerebral palsy, microcephaly, and behavioral issues.
- Over 50% of the BPD cohort experienced gross and/or fine motor skill difficulties.
- Postural stability differed significantly between the groups, and illness severity markers correlated with motor outcomes.
Conclusions:
- Children with severe BPD requiring home oxygen therapy are at increased risk for significant neuromotor impairments at school age.
- Preventing cardiorespiratory complications is vital to minimize long-term disability.
- Timely identification and remediation of neuromotor deficits are essential for optimizing functional potential in children with severe BPD.
Abstract:
Preterm children who develop severe chronic lung disease may be developmentally compromised by exposure to hypoxic episodes. This study aims to determine if children with severe bronchopulmonary dysplasia (BPD) who required home oxygen therapy were at greater risk for neurological and motor deficits at school age than preterm peers without BPD. This study evaluated 27 subjects with BPD and 27 preterm control infants matched for gestational age, birthweight, sex, and year of birth at a mean age of 9.9 years (2.0 SD) using standardized neuromotor outcome measures. Pair-matched comparisons and regression analyses were used to determine if subjects with BPD were at increased risk for neuromotor sequelae. Neurological abnormalities, including subtle neurological signs, cerebral palsy, microcephaly, and behavioral difficulties were highly prevalent in the BPD group (71% compared with 19% in control group, P<0.005). Over half the BPD cohort had difficulties in gross and/or fine motor skills. There were significant differences in postural stability between groups. Duration of hospitalization and home oxygen treatment, and decreased lung function at school age, markers of severity of illness, correlated with motor outcomes. The findings underline the importance of preventing the cardiorespiratory complications associated with chronic lung disease to minimize disability in preterm children. For children with severe BPD, better recognition and subsequent remediation of neuromotor impairments that manifest at school age may help maximize their functional potential.