Objective: To assess the risk and the degree of possible unfavourable development in neonates with bronchopulmonal dysplasia and with congenital diaphragmatic hernia.
Design: Longitudinal monitoring of the mental, motoric and neurological development until the age of 2 years. Comparison of the findings with the result of polygraphic examination carried out at the expected time of birth.
Methods: The following children were monitored: a) 38 children with bronchopulmonal dysplasia born between the 24th and 33rd post-conception weeks; b) 18 children with congenital diaphragmatic hernia, of whom 3 children were born between the 34th and 36th post-conception weeks, while the remaining 15 children were born on the expected date. All children underwent polygraphic examinations (EEG - 8 channels, respiration, EKG, EOG and EMG) between the 38th and 42nd post-conception weeks. During the 1st and the 2nd years, their psychomotoric development and neurological status were repeatedly evaluated according to Bayley and Vlach, respectively.
Results: Up until the 2nd year of life, approximately 2/3 of the children in both monitored groups were developing favourably or satisfactorily. However, the development of the remaining 1/3 was not favourable: The children were mentally or motorically retarded and/or cerebral palsy developed in them. The polygraphic examination in the neonatal period predicted the favourable or unfavourable development of the monitored children with high probability.
Conclusion: The study showed that in accordance with the data stated in the literature, the development of neural functions is seriously affected in a relatively high percentage of neonates with severe pneumopathy. Neonatal polygraphy can contribute to timely determination of the prognosis for these children. Children with serious neonatal pneumopathies need to be provided with dispensary care on a long-term basis, and professional consultancy and intervention programmes need to be ensured for them.