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Factors Associated with Neurodevelopmental Impairment in Bronchopulmonary Dysplasia
Sarah E Bauer1, Lydia Schneider2, Susan K Lynch3
1Department of Pediatrics, The Ohio State University, Columbus, OH.
Insights
Lower birth weight and longer hospital stays increase the risk of neurodevelopmental impairment (NDI) in infants with bronchopulmonary dysplasia (BPD). Addressing these factors may improve outcomes for these vulnerable patients.
Area of Science:
- Neonatology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Neurodevelopmental impairment (NDI) is a common complication in survivors of BPD.
- Identifying risk factors for NDI is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To determine factors associated with neurodevelopmental impairment (NDI) in patients diagnosed with moderate to severe bronchopulmonary dysplasia (BPD).
- To analyze the relationship between birth weight, hospital stay duration, and the incidence of NDI in BPD patients.
Main Methods:
- Retrospective analysis of 151 patients with moderate to severe BPD.
- Assessment of neurodevelopmental outcomes using Bayley Scales of Infant Development (BSID) at 24 months corrected age.
- Statistical analysis, including logistic regression, to identify significant risk factors for NDI.
Main Results:
- 15% of patients were diagnosed with cerebral palsy, and 18-37% exhibited scores below 80 in cognitive, communication, or motor domains.
- Lower birth weight was significantly associated with an increased risk of NDI (35% decrease in odds per 100g increase).
- Longer hospital stay (1.3% increase in odds per day) and use of furosemide and systemic corticosteroids were also linked to higher NDI risk.
Conclusions:
- The majority of infants with moderate to severe BPD in this cohort did not have NDI.
- Low birth weight and prolonged hospital stay are significant risk factors for NDI in BPD patients.
- These findings highlight potentially modifiable factors that warrant further investigation to enhance neurodevelopmental outcomes in infants with BPD.
Objective:
To identify factors associated with neurodevelopmental impairment (NDI) in patients with bronchopulmonary dysplasia (BPD).
Study Design:
We identified 151 patients with moderate to severe BPD from 2010 to 2014 with complete Bayley Scales of Infant Development (BSID) scores at 24 months corrected age. We defined NDI as any diagnosis of cerebral palsy or ≥1 BSID composite scores of <80.
Results:
The mean corrected age at BSID was 23 ± 1 months; 18% had a cognitive score of <80, 37% had a communication score of <80, and 26% had a motor score of <80. Cerebral palsy was diagnosed in 22 patients (15%); 84 (56%) patients did not have NDI. Patients with NDI had lower birth weight, but there was no difference in gestational age at birth, severe intraventricular hemorrhage (IVH), necrotizing enterocolitis, or patent ductus arteriosus ligation compared with patients with no NDI. Ventilator days were greater in patients with NDI than in patients without NDI. More patients with NDI received furosemide and systemic corticosteroids and the hospital length of stay was longer than in patients with no NDI. Logistic regression modeling demonstrated that for every additional 100 g of birth weight the odds of NDI decreased by 35% and for every additional hospital day the odds of NDI increased by 1.3%.
Conclusions:
In our cohort of patients with moderate to severe BPD, the majority had no NDI, and low birth weight and length of hospital stay were associated with increased risk of developing NDI. This finding suggests that there are potentially modifiable factors associated with better neurodevelopmental outcomes in patients with BPD that deserve further study.
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