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The effect of bronchopulmonary dysplasia on growth at school age
L A Vrlenich1, M E Bozynski, Y Shyr
1Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, USA.
Insights
Bronchopulmonary dysplasia (BPD) in children did not significantly impact school-age growth after accounting for confounding factors. Initial differences in weight and head circumference were not sustained, suggesting other variables influence growth outcomes.
Area of Science:
- Pediatric Pulmonology
- Neonatal Health
- Growth and Development
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Long-term growth deficits are often associated with BPD.
- The independent effect of BPD on school-age growth requires further investigation.
Purpose of the Study:
- To assess the impact of BPD on growth parameters at school age.
- To differentiate the direct effects of BPD from confounding factors on child development.
Main Methods:
- Prospective cohort study of 406 children aged 8-10 years, born with very low birth weight.
- Measured height, weight, and head circumference.
- Collected data on sociodemographic and neonatal confounders.
Main Results:
- Children with BPD showed smaller weight and head circumference initially.
- After controlling for confounders, no significant growth differences between BPD and non-BPD groups were found.
- Previously documented associations between BPD and confounders were confirmed.
Conclusions:
- Initial growth differences in children with BPD were not significant after adjusting for confounders.
- The study suggests that factors other than BPD itself may explain previously reported poor growth.
- BPD's direct long-term impact on growth at school age may be less pronounced than previously thought.
Objective:
To determine the effect of bronchopulmonary dysplasia (BPD) on growth at school age.
Design:
A prospective cohort study.
Methods:
The sample included 406 children selected from a reconstructed cohort of infants of very low birth weight previously enrolled in a multisite, randomized, controlled clinical trial. The children were contacted at 8 to 10 years of age. Height, weight, and head circumference (HC) were measured. Possible confounders including sociodemographic data, and neonatal factors were also recorded.
Results:
The children in the BPD group were significantly smaller in weight (z score, -0.50 +/- 1.19 SD vs -0.06 +/- 1.30 SD) and HC (z score, -1.41 +/- 1.32 SD vs -0.63 +/- 1.62 SD) than those without BPD. However, after controlling for cofounders (using analysis of covariance), no significant differences were demonstrated between the two groups. Power analyses showed that a difference of at least 0.43 z score units could have been detected. The previously documented associations between BPD and suspected confounders were reconfirmed.
Conclusions:
Significant differences were noted between children with and without BPD for weight and HC but not height. When possible confounders were taken into account, the differences were no longer appreciated. Thus, the previously reported poor growth in children with BPD may have been related to other factors and not necessarily to BPD.