Related Experiment Videos
Neurodevelopmental status of low birth weight infants with bronchopulmonary dysplasia requiring prolonged oxygen
M H Lifschitz1, D K Seilheimer, G S Wilson
1Department of Pediatrics, Baylor College of Medicine, Houston.
Insights
Bronchopulmonary dysplasia (BPD) survivors often experience significant neurodevelopmental abnormalities. Intracranial hemorrhage, air leaks, and longer hospital stays predict poorer outcomes in these infants.
Area of Science:
- Neonatology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Infants with BPD often require prolonged respiratory support and intensive care.
- Long-term outcomes for BPD survivors, particularly neurodevelopmental, require further investigation.
Purpose of the Study:
- To assess the clinical course and neurodevelopmental outcomes of infants with BPD after Neonatal Intensive Care Unit (NICU) discharge.
- To identify predictive factors for clinical and neurodevelopmental outcomes in BPD survivors.
- To evaluate the impact of home oxygen therapy on neurodevelopmental status.
Main Methods:
- Prospective follow-up of 50 infants with BPD (birth weight ≤1500g) to a mean age of 25 months.
- Assessment of clinical course, including feeding problems, growth, and need for home oxygen therapy.
- Neurodevelopmental assessment using standardized measures, including hearing, vision, motor function, and developmental scores.
Main Results:
- High rates of abnormalities observed: 11 hearing impaired, 10 legally blind, 14 with cerebral palsy, 23 with abnormal development scores.
- Feeding problems (21 infants) and failure to thrive (26 infants) were common.
- 50% of infants required home oxygen therapy; these infants had greater illness severity and longer hospital stays but similar neurodevelopmental outcomes compared to those discharged on room air.
- Intracranial hemorrhage, pulmonary air leak, and length of hospital stay were associated with neurodevelopmental outcomes.
Conclusions:
- Bronchopulmonary dysplasia survivors face a high burden of neurodevelopmental impairments.
- Home oxygen therapy, despite associated with greater illness severity, did not negatively impact neurodevelopmental status at follow-up.
- Intracranial hemorrhage, pulmonary air leak, and prolonged hospitalization are significant predictors of adverse neurodevelopmental outcomes in BPD survivors.
Abstract:
Fifty infants weighing 1,500 g or less at birth with a diagnosis of bronchopulmonary dysplasia (BPD) were followed to a mean age of 25 months to determine their clinical course and short-term neurodevelopmental outcome after discharge from the Neonatal Intensive Care Unit, and to identify possible predictive factors for outcome. Because study participation was voluntary, the subjects may not have represented the total population of BPD survivors. Occurrences of abnormalities were high: 11 hearing impaired, 10 legally blind, 14 cerebral palsy, and 23 abnormal development scores. Twenty-one subjects had feeding problems and weight was below the fifth percentile in 26. Home-oxygen therapy was required by 50 per cent of the subjects. Although severity of illness, duration of oxygen therapy and feeding problems were greater among those sent home on oxygen, their neurodevelopmental status did not differ from that of infants breathing room air by discharge. Factors associated with neurodevelopmental outcome were intracranial hemorrhage, pulmonary air leak, and length of hospital stay.