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Published on: August 25, 2014
Neurodevelopmental outcomes in infants with bronchopulmonary dysplasia: a single-center retrospective cohort study
Yao Sun1, Rong-Ping Xu2, Bei-Bei Wang2
1Department of Pediatric, Lishui Branch of Zhongda Hospital, Southeast University, Nanjing 211200, PR China.
Insights
Bronchopulmonary dysplasia (BPD) is linked to poorer neurodevelopmental outcomes in preterm infants. Early screening and follow-up are crucial for these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Pediatric Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants.
- Long-term neurodevelopmental outcomes in BPD survivors are not well understood.
Purpose of the Study:
- To investigate the association between BPD and neurodevelopmental outcomes at 12 months corrected age.
- To identify the impact of BPD on infant development.
Main Methods:
- Retrospective cohort study of 356 preterm infants (GA ≤35 weeks).
- 102 infants had BPD, 254 served as controls.
- Neurodevelopment assessed using Gesell Developmental Scale at 3, 6, 9, and 12 months corrected age.
Main Results:
- BPD group had lower GA, birthweight, and Apgar scores.
- BPD infants showed significantly lower Gesell scores across all domains at all time points.
- BPD independently associated with lower developmental quotient (DQ) at 12 months (β = -0.32, P = 0.009).
- BPD mediated significant portions of the effects of GA and birthweight on neurodevelopment.
Conclusions:
- BPD is significantly associated with adverse neurodevelopmental outcomes in preterm infants at 12 months corrected age.
- Early neurodevelopmental screening and multidisciplinary follow-up are recommended for preterm infants with BPD.
Background:
Bronchopulmonary dysplasia (BPD) is a chronic lung disease, but its association with long-term neurodevelopmental outcomes remains unclear. This study aimed to investigate the association between BPD and neurodevelopmental outcomes at 12 months of corrected age.
Methods:
This single-center retrospective cohort study included 356 preterm infants (gestational age [GA] ≤35 weeks), of whom 102 (28.7%) had BPD and 254 (71.3%) served as non-BPD controls. Neurodevelopmental outcomes were assessed using the Gesell Developmental Scale at 3, 6, 9, and 12 months of corrected age across five domains.
Results:
Compared with non-BPD infants, the BPD group had significantly lower GA, birthweight, and Apgar scores, and higher rates of comorbidities. The BPD group consistently demonstrated significantly lower Gesell scores across all five domains at each time point. Multivariable linear regression confirmed that BPD was independently associated with a lower mean DQ at 12 months (β = -0.32, 95% CI: -0.55 to -0.08, P = 0.009). Restricted cubic spline curves demonstrated that the neurodevelopmental benefits of higher GA and birthweight were most pronounced in the most preterm and low-birthweight infants. Mediation analyses revealed that BPD mediated 41.5% of the effect of birthweight and 72.0% of the effect of GA on neurodevelopmental outcomes. Notably, although the BPD group achieved catch-up growth by 3 months, this did not translate into improved developmental scores.
Conclusions:
BPD is significantly associated with adverse neurodevelopmental outcomes at 12 months of corrected age in preterm infants. Early neurodevelopmental screening and multidisciplinary follow-up for preterm infants with BPD are strongly recommended.
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