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Behavior Profiles at 2 Years for Children Born Extremely Preterm with Bronchopulmonary Dysplasia

Jane E Brumbaugh1, Edward F Bell2, Scott F Grey3

  • 1Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.

The Journal of Pediatrics
|February 4, 2020
PubMed

Insights

Bronchopulmonary dysplasia (BPD) severity impacts child behavior, increasing withdrawn tendencies and developmental issues while decreasing sleep and aggression problems. Cognitive, language, and motor skills play a mediating role in these behavioral outcomes.

Area of Science:

  • Neonatal Medicine
  • Developmental Psychology
  • Pediatric Neurology

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
  • Understanding the long-term behavioral outcomes associated with BPD severity is crucial for early intervention.
  • Previous research has indicated potential links between prematurity, BPD, and neurodevelopmental challenges.

Purpose of the Study:

  • To investigate the relationship between the severity of bronchopulmonary dysplasia (BPD) and behavioral characteristics in 2-year-old children.
  • To identify specific behavioral patterns associated with different grades of BPD.
  • To explore the mediating role of cognitive, language, and motor skills in the BPD-behavior relationship.

Main Methods:

  • A cohort of children born between 22-26 weeks of gestation were assessed at 22-26 months corrected age using the Child Behavior Checklist (CBCL).
  • BPD severity was categorized based on respiratory support requirements at 36 weeks postmenstrual age.
  • Statistical analyses, including mediation analysis, were employed to examine the associations between BPD grade and CBCL syndrome scales, controlling for perinatal factors.

Main Results:

  • Higher grades of BPD were significantly associated with increased withdrawn behavior and pervasive developmental problems (P < .001).
  • Conversely, worsening BPD grade correlated with decreased sleep problems (P = .008) and aggressive behavior (P = .023).
  • Cognitive, language, and motor skills mediated the impact of BPD grade on specific behavioral issues like attention problems and emotional reactivity.

Conclusions:

  • The severity of bronchopulmonary dysplasia (BPD) is linked to distinct behavioral profiles in young children, characterized by both increased and decreased risks for certain behaviors.
  • The observed behavioral associations are complex and influenced by developmental factors.
  • Targeted support for cognitive, language, and motor development may be important for mitigating behavioral challenges in children with BPD.
Abstract

Keywords:
BPDbayley scales of infant and toddler developmentchild behavior checklistcognitiveinfants born prematurelanguagemotor

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