Need for Supplemental Oxygen at Discharge in Infants with Bronchopulmonary Dysplasia Is Not Associated with Worse Neurodevelopmental Outcomes at 3 Years Corrected Age

Abstract

ObjectivesTo determine if chronic oxygen dependency (discharge home on supplemental oxygen) in children with bronchopulmonary dysplasia (BPD; defined as requirement for supplemental O2 at 36 weeks postmenstrual age) predicts neurodevelopmental disability rates and growth outcomes at 36 months corrected age (CA).Study DesignLongitudinal cohort study.SettingSouthern Alberta regional center located at high altitude.ParticipantsPreterm infants weighing ≤1250 grams with no BPD, BPD, and BPD with chronic oxygen dependency.Main outcome measuresNeurodevelopmental and growth outcomes.ResultsOf 1563 preterm infants admitted from 1995–2007, 1212 survived. Complete follow-up data were available for 1030 (85%) children. Children in BPD and BPD with chronic oxygen dependency groups had significantly lower birth weights, gestational ages, prolonged mechanical ventilation and oxygen supplementation and received more postnatal steroids, compared to those without BPD. Children with BPD and BPD with chronic oxygen dependency were more likely to be below the 5th centile in weight and height compared to those without BPD but there was little difference between the BPD and BPD with chronic oxygen dependency groups. After controlling for confounding variables, children who had BPD and BPD with chronic oxygen dependency had higher odds of neurodevelopmental disability compared to those without BPD [OR (odds ratio) 1.9 (95%CI 1.1 to 3.5) and OR 1.8 (1.1 to 2.9), respectively], with no significant difference between BPD and BPD with chronic oxygen dependency [OR 0.9 (95% CI 0.6 to 1.5)].ConclusionsBPD and BPD with chronic oxygen dependency in children predicts abnormal neurodevelopmental outcomes at 36 months CA. However, the neurodevelopmental disability rates were not significantly higher in BPD with chronic oxygen dependency children compared to children with BPD only. Compared to those without BPD, growth is impaired in children with BPD and BPD with chronic oxygen dependency, but no difference between the latter two groups.

Chorioamnionitis at birth does not increase the risk of neurodevelopmental disability in premature infants with bronchopulmonary dysplasia

“…Our study results provide evidence that help to eliminate an uncertainty of a previous study where authors did not find any additional contribution of chorioamnionitis on perinatal brain injury and subsequent adverse neurodevelopmental outcomes in premature infants with BPD . Our study results further reinforce that BPD is the major contributing factor associated with any NDD in premature infants, similar to a previous study .…”

“…The Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI‐III) or the Stanford‐Binet Intelligence Test, Fourth Edition (SB‐IV) were used to assess cognition. Hearing evaluation was performed by visual reinforcement audiometry, otoscopy and tympanometry at four months CA . These assessments were retrieved from the charts and entered into the Neonatal Follow‐Up Clinic database by the same research assistant.…”

“…Motor disability was classified as mild CP characterised by abnormal tone and reflexes with no limitation of activities of daily living, and moderate–severe CP was considered if the child required appliances or help with activities of daily living . Cognitive disability was categorised based on cognitive score: as borderline if the score was 1–2 standard deviations (SD) below the mean and as cognitive delay if the score was >2 SD below the mean on the above‐mentioned standardised tests . Mild visual disability was defined as corrected visual acuity <20/60 but >20/200 in the better eye, significant refractive errors such as severe myopia or significant hypermetropia, or unilateral blindness.…”

“…BPD is a major sequela of extreme prematurity and is associated with significant NDD . Kobaly et al.…”

Expression dynamics of caveolin-1 in fibroblasts of newborn rats with chronic lung disease and its impact on lung fibroblast proliferation

“…CLD, caused by prolonged inhalation of high concentrations of oxygen, is a primary disease threatening the health and life of preterm children 9,10 . Although the exact pathogenesis of CLD is not well understood, the outcome of this pathological process is clearinterstitial pulmonary fibrosis 11 .…”