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Neurodevelopmental outcome of preterm infants with bronchopulmonary dysplasia
P H Gray1, Y R Burns, H A Mohay
1Mater Misericordiae Hospitals, South Brisbane, Queensland, Australia.
Insights
Bronchopulmonary dysplasia (BPD) in infants does not independently predict adverse neurodevelopmental outcomes. Factors like periventricular hemorrhage and sepsis are key predictors of disability, not BPD itself.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Neurodevelopmental outcomes in infants with BPD require further investigation.
Purpose of the Study:
- To compare the neurodevelopmental outcomes of infants with BPD to matched controls.
- To assess the impact of BPD severity on neurodevelopmental disability.
- To identify predictors of neurodevelopmental disability in infants with severe BPD (sBPD).
Main Methods:
- A cohort study comparing 78 infants with BPD to 78 matched controls.
- Follow-up to 2 years corrected age, assessing neurological impairment, developmental delay, and disability.
- Subgroup analysis of 62 infants with sBPD (requiring oxygen at 36 weeks' postmenstrual age).
Main Results:
- Infants with BPD showed a trend towards more frequent neurological impairment and developmental delay, but not statistically significant.
- Severe BPD (sBPD) was associated with a higher incidence of neurodevelopmental disability (OR 3.6).
- Periventricular hemorrhage, ventricular dilatation, and sepsis were significant predictors of disability in sBPD infants.
- After adjusting for these factors, the association between BPD and disability was no longer significant (OR 0.9).
Conclusions:
- Bronchopulmonary dysplasia is not independently associated with adverse neurodevelopmental outcomes.
- Factors such as periventricular hemorrhage, ventricular dilatation, and sepsis are significant contributors to neurodevelopmental disability in infants with BPD.
- Clinical management should focus on addressing these specific risk factors to improve neurodevelopmental outcomes.
Abstract:
The neurodevelopmental outcome of 78 infants with bronchopulmonary dysplasia (BPD) was compared with that of 78 control infants matched for birthweight. To determine the effect of the severity of BPD, 62 infants requiring oxygen at 36 weeks' postmenstrual age (sBPD) were compared with their matched controls. Infants were followed up to 2 years of age, corrected for prematurity, and were classified for neurological impairment, developmental delay, and neurodevelopmental disability. Seventy six (98%) BPD infants and 71 (91%) controls had follow up data available to two years. Neurological impairment, developmental delay, and neurodevelopmental disability occurred more frequently in infants with BPD than in controls but this was not significant. For infants with sBPD, the increased incidence of neurological impairment and definite developmental delay was not significant when compared with the controls, though neurodevelopmental disability occurred more frequently (odds ratio (OR) 3.6: 95% confidence intervals (CI) 1.1-11.8). Predictors of disability in infants with sBPD included periventricular haemorrhage (OR 19.4: 95% CI 4.3-86.6), ventricular dilatation (OR 12.8: 95% CI 2.9-57.3), and sepsis (OR 5.0: 95% CI 1.3-19.4). Adjusting for the presence of these factors, the association between BPD and disability was no longer apparent (OR 0.9: 95% CI 0.2-3.6). The findings suggest that BPD is not independently associated with adverse neurodevelopmental outcome.