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Eight-year school performance, neurodevelopmental, and growth outcome of neonates with bronchopulmonary dysplasia: a
C M Robertson1, P C Etches, E Goldson
1University of Alberta, Edmonton, Canada.
Insights
Longer oxygen use in preterm infants with bronchopulmonary dysplasia (BPD) was linked to lower intelligence, but growth was similar. BPD infants showed poorer academic outcomes than peers.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Developmental Pediatrics
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Oxygen therapy duration varies among BPD infants, potentially impacting long-term outcomes.
- Longitudinal studies are crucial for understanding the developmental trajectory of BPD survivors.
Purpose of the Study:
- To evaluate the eight-year physical growth and psychoeducational outcomes of preterm infants with BPD.
- To compare outcomes across different oxygen therapy durations and severities of BPD.
- To identify factors influencing academic achievement in BPD survivors.
Main Methods:
- Longitudinal study of three BPD groups based on gestation and oxygen use, plus matched neonatal and term peer comparison groups.
- Assessment of physical growth, intelligence quotient (IQ), and school performance at eight years.
- Multivariate analysis to identify predictors of academic achievement.
Main Results:
- Physical growth and general psychoeducational scores were similar across BPD groups, except for lower IQ in those with longest oxygen exposure.
- BPD infants (Groups 1 & 2) had outcomes similar to neonatal controls but significantly lower than term peers.
- Lowest recorded pH, father's socioeconomic status, and lowest PaO2 predicted academic achievement in one BPD group.
- Academic delay persisted in BPD groups even after excluding disabled children.
Conclusions:
- Extended oxygen use in preterm infants with BPD may be associated with cognitive deficits.
- Preterm infants with BPD experience long-term academic disadvantages compared to term peers.
- Early physiological factors and socioeconomic status significantly influence academic outcomes in BPD survivors.
Abstract:
Eight-year outcome is reported for three groups of preterm infants with bronchopulmonary dysplasia--group 1 with a birth gestation of less than or equal to 31 weeks receiving supplemental oxygen until the equivalent of 36 weeks' gestation, group 2 of the same gestation receiving supplemental oxygen to 28 days postnatal age but not to 36 weeks gestational age, and group 3 with a gestation of greater than or equal to 32 weeks requiring supplemental oxygen for greater than 28 days--and for an individually matched preterm neonatal comparison group and a term peer comparison group for each bronchopulmonary dysplasia group. The subjects all had parents whose mother tongue was English and were matched for gender, mother's education, and father's socioeconomic status, and in the case of the neonatal comparison groups they also were matched for birth gestation and birth weight. Physical growth and psychoeducational and school performance test scores were similar for the three bronchopulmonary dysplasia study groups with the exception of lower intelligence quotient for those receiving supplemental oxygen for the longest time. Children in groups 1 and 2 had outcome scores similar to those of the neonatal comparison group and significantly below those of their peer comparison groups. On multivariate analysis for group 1 children, 61% of the variance of academic achievement was related to lowest recorded pH, father's socioeconomic status, and lowest recorded PaO2. Compared with the peer groups, the study groups continued to show academic delay when the disabled children were excluded from analysis.(ABSTRACT TRUNCATED AT 250 WORDS)