Otologic outcomes in infants and children with bronchopulmonary dysplasia

Hearing outcomes among children with bronchopulmonary dysplasia (BPD) have not been well characterized across disease severity, and the impact of neighborhood-level opportunity on otologic outcomes remains unclear. We aimed to determine the prevalence of hearing loss (HL), middle ear pathology, and surgical management among children with BPD stratified by disease severity, and to evaluate the contribution of the Childhood Opportunity Index (COI) to otologic-related disparities.

We performed a single-institution, retrospective cohort study of children aged 0-8 years admitted to a tertiary care neonatal intensive care unit and diagnosed with BPD. Patients were grouped by BPD severity (Jensen criteria). Outcomes included newborn hearing screening (NBHS) results, diagnostic audiology evaluation (DE), history of middle ear pathology, and time to tympanostomy tube placement. Models were adjusted for gestational age and birthweight.

Of 1077 records, 924 were included. NBHS outcomes varied by BPD severity (p < 0.001), and among patients with completed DE, those with more severe BPD had a higher risk of permanent HL (p < 0.001). The prevalence of conductive HL, middle ear pathology, and surgical management did not differ significantly between grades. 57% of the cohort received the recommended DE. Low COI was independently associated with lower odds of completing DE.

Infants with greater BPD severity have a higher risk of non-pass NBHS and permanent HL and should undergo close monitoring for evaluation and treatment. Children with BPD from low-opportunity neighborhoods may experience reduced access to DE and otologic care, highlighting the need for equitable care strategies.

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