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Growth and development in children recovering from bronchopulmonary dysplasia
Insights
Most infants with bronchopulmonary dysplasia (BPD) survived and experienced improved respiratory health. However, many had residual lung changes and growth catch-up, with development linked to early life events, not BPD severity.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants.
- Long-term outcomes regarding respiratory health, growth, and development in BPD survivors are crucial.
Purpose of the Study:
- To prospectively evaluate the two-year post-term outcomes of infants with BPD.
- To assess respiratory morbidity, growth patterns, and neurodevelopmental status in BPD survivors.
Main Methods:
- Prospective follow-up of 26 infants diagnosed with BPD.
- Assessment of respiratory symptoms, hospitalizations, radiographic changes, growth parameters, and developmental scores (Bayley scales).
Main Results:
- Of 20 survivors, 85% experienced lower respiratory tract infections, with 50% requiring hospitalization in the first year.
- At two years, 78% had residual radiographic changes, but only 2 patients had resting respiratory symptoms.
- Significant growth catch-up was observed, with developmental outcomes primarily related to perinatal/neonatal factors.
Conclusions:
- BPD survivors show significant respiratory morbidity and radiographic abnormalities but often achieve catch-up growth.
- Neurodevelopmental outcomes in BPD patients appear more influenced by perinatal and neonatal events than BPD severity.
- Long-term monitoring is essential for managing respiratory and growth issues in BPD survivors.
Abstract:
Of 26 patients with bronchopulmonary dysplasia, 20 (77%) survived and were followed prospectively for two years post-term. Lower respiratory tract infections occurred in 17 of the 20 children (85%), and required hospitalization in ten (50%) during the first and in four (20%) during the second year. At two years post-term only two patients had significant respiratory symptoms at rest, but 78% had residual radiographic changes. The average weight and height at term were at or below the third percentile. Growth occurred at an accelerated rate with improvement of respiratory symptoms, with average weight reaching the third to tenth percentile for both sexes, and tenth to twenty-fifth percentile for height in the boys and the twenty-fifth percentile for the girls by two years post-term. Growth retardation was associated with severe and prolonged respiratory dysfunction. Fifteen (75%) were free of major developmental defects. Five had mean Bayley scores less than 85 at 18 months post-term; one also had hydrocephalus. Developmental outcome seems related to perinatal and neonatal events rather than to the presence or absence of BPD.