Predictors of Neurodevelopmental Outcome Following Bronchopulmonary Dysplasia

Luchi, Jean M.; Bennett, Forrest C.; Jackson, J. Craig

doi:10.1001/archpedi.1991.02160070109031

Cited by 22 publications

(13 citation statements)

References 18 publications

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“…Some authors 24 -26 have reported that infants with BPD present more developmental delays than do preterm infants without BPD, but others 12,14,21,27 did not support that finding. Teberg et al 24 and Gray and coworkers 28 concluded that VLBW and preterm infants with BPD present a higher risk of neurodevelopmental delay but that this risk is associated with neonatal brain lesions and not respiratory problems.…”

Section: Discussionmentioning

confidence: 97%

Health and Developmental Outcomes at 18 Months in Very Preterm Infants With Bronchopulmonary Dysplasia

1998

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Section: Discussionmentioning

confidence: 97%

Health and Developmental Outcomes at 18 Months in Very Preterm Infants With Bronchopulmonary Dysplasia

1998

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“…30 Prolonged ventilator and oxygen dependence may result in repeated episodes of hypoxia and acidosis leading to hypoxic-ischemic cerebral injury and increased mortality and morbidity. [31][32][33] Laboratory confirmation of such chronic hypoxia is seen in the frequent finding of polycythemia. BPD spells secondary to reactive airways or esophageal reflux can be expected to result in chronic episodic hypoxia.…”

Section: Discussionmentioning

confidence: 99%

A Longitudinal Study of Developmental Outcome of Infants With Bronchopulmonary Dysplasia and Very Low Birth Weight

et al. 1997

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Objective-Bronchopulmonary dysplasia (BPD) is now the leading cause of lung disease in US infants. In a large regional cohort, we tested the hypothesis that despite innovations in neonatal care, very low birth weight (VLBW) infants (<1500 g) with BPD had poorer developmental outcomes than nonaffected infants during the first 3 years of life, and that BPD predicted poorer outcome beyond the effects of other risk factors.Methods-Three groups of infants (122 with BPD, 84 VLBW without BPD, and 123 full-term) were followed longitudinally to 3 years of age with the Bayley Scales of Mental and Motor Development. Comparison groups of VLBW infants without BPD and full-term infants did not differ in sex, race, or socioeconomic status. Statistical analyses included hierarchical and stepwise multiple regression.Results-Infants with BPD performed more poorly at all ages. By 3 years, cognitive and/or motor development was in the range of retardation (<70 standard score) for 21% to 22% of infants with BPD. In multiple regression analyses controlling for socioeconomic and neonatal risk conditions, BPD had an independent negative effect on motor outcome at 3 years. Neurologic risk, a summary measure of neurologic problems other than intraventricular hemorrhage, and the presence of BPD independently predicted motor delay. By 3 years, social class, race, and neurologic risk predicted mental outcome, suggesting that the specific effects of BPD are primarily on the motor domain.Conclusions-In VLBW infants, BPD predicts poorer motor outcome at 3 years, after control for other risks. Cohorts of infants with BPD also had higher rates of mental retardation, associated Copyright © 1997 with greater neurologic and social risk. These findings underscore the need for intensive prevention and habilitation efforts for this growing group of VLBW survivors, as well as investigation into the potential role of BPD in the higher rates of learning disabilities in VLBW cohorts at school age.Improved survival rates for smaller, sicker, very low birth weight (VLBW) infants related to advances in neonatal intensive care have resulted in a corollary increase in incidence of bronchopulmonary dysplasia (BPD). 1 BPD, virtually unknown a generation ago, is now the third leading cause of chronic lung disease in children, and the leading cause of lung disease in infants in the United States, 2,3 with >7000 infants diagnosed yearly.BPD is the term used to describe the clinical, radiographic, and pathologic sequelae of prolonged mechanical ventilation occurring in the lungs of some newborn infants. 1 BPD most often occurs in ventilated preterm infants and is inversely related to gestational age. 4 Pulmonary immaturity, oxygen toxicity, and barotrauma are paramount in the etiology of BPD. 4,5 Previous studies addressing developmental outcome for infants with BPD have been inconsistent in their findings, with many reporting poorer growth and developmental outcomes and greater evidence of neurologic problems, particularly cerebral palsy. [5][6][7][8][9][...

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“…Overstreet et al 3 reported 35% mortality in 58 babies ventilated by day 60 of age. In contrast, Luchi et al 4 found no significant correlation between duration of mechanical ventilation and adverse neurological outcome at 36 months in a cohort of 27 babies with a mean birth weight of 940 g and mean gestation of 27 postmenstrual weeks ventilated for 22–128 days (44% were normal at 3 years and 22% had major disability). The babies in these studies were all born in 1980–1992 and most of them were not treated with antenatal steroids or exogenous surfactant.…”

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confidence: 87%

Improved survival and neurodevelopmental outcome after prolonged ventilation in preterm neonates who have received antenatal steroids and surfactant

Gaillard

Cooke

Shaw

2001

Arch Dis Child Fetal Neonatal Ed

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Aims-To assess survival and neurodevelopmental outcome following prolonged ventilation beyond 27 or 49 days of postnatal life in neonates treated with antenatal steroids and surfactant. Methods-The medical records of 84 babies born in 1994-1996 requiring ventilation after 27 postnatal days at Liverpool Women's Hospital were reviewed to determine the duration of mechanical ventilation, survival, and neurodevelopmental outcome at 3 years of age. Results-Fifty six babies were mechanically ventilated after 27 postnatal days but for less than 50 days; 48 (86%) survived to 3 years. Twenty six (54%) of the survivors had normal neurodevelopment at 3 years and seven (15%) had only mild disability. Twenty eight babies were ventilated after 49 postnatal days; 14 survived to 3 years. Five of these survivors were neurodevelopmentally normal at 3 years and two had mild disability. Conclusions-Survival decreases with more prolonged ventilation. When antenatal steroids and postnatal surfactant are used, there appears to be improved survival and neurodevelopmental outcome in preterm babies who require prolonged ventilation. (Arch Dis Child Fetal Neonatal Ed 2001;84:F194-F196)

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Predictors of Neurodevelopmental Outcome Following Bronchopulmonary Dysplasia

Cited by 22 publications

References 18 publications

Health and Developmental Outcomes at 18 Months in Very Preterm Infants With Bronchopulmonary Dysplasia

Health and Developmental Outcomes at 18 Months in Very Preterm Infants With Bronchopulmonary Dysplasia

A Longitudinal Study of Developmental Outcome of Infants With Bronchopulmonary Dysplasia and Very Low Birth Weight

Improved survival and neurodevelopmental outcome after prolonged ventilation in preterm neonates who have received antenatal steroids and surfactant

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