Neurodevelopmental outcomes of extremely preterm infants with bronchopulmonary dysplasia (BPD) - A retrospective cohort study

Khoa L Nguyen; Dominic A Fitzgerald; Annabel Webb; Barbara Bajuk; Himanshu Popat

doi:10.1016/j.prrv.2024.02.004

Neurodevelopmental outcomes of extremely preterm infants with bronchopulmonary dysplasia (BPD) - A retrospective cohort study

Paediatr Respir Rev. 2024 Mar 1:S1526-0542(24)00021-6. doi: 10.1016/j.prrv.2024.02.004. Online ahead of print.

Authors

Khoa L Nguyen¹, Dominic A Fitzgerald², Annabel Webb³, Barbara Bajuk⁴, Himanshu Popat⁵

Affiliations

¹ The Children's Hospital at Westmead, Locked Bag 4001 Westmead, NSW, 2145, Australia. Electronic address: khoa.nguyen@health.nsw.gov.au.
² The Children's Hospital at Westmead, Locked Bag 4001 Westmead, NSW, 2145, Australia; Discipline of Child and Adolescent Health, Children's Hospital at Westmead Clinical School, Faculty of Medicine, Discipline of Health Sciences, University of Sydney, NSW, Australia.
³ Cerebral Palsy Alliance Research Institute, Sydney, Australia.
⁴ Neonatal Intensive Care Units' (NICUS) Data Collection, NSW Pregnancy and Newborn Services Network (PSN) , Australia.
⁵ The Children's Hospital at Westmead, Locked Bag 4001 Westmead, NSW, 2145, Australia; Discipline of Child and Adolescent Health, Children's Hospital at Westmead Clinical School, Faculty of Medicine, Discipline of Health Sciences, University of Sydney, NSW, Australia; NHMRC Clinical Trial Centre, Levels 4-6 Medical Foundation Building, 92-94 Parramatta Rd, Camperdown, NSW 2050, Australia.

PMID: 38490918
DOI: 10.1016/j.prrv.2024.02.004

Abstract

Objective: To investigate the neurodevelopmental outcomes for preterm infants born < 29 weeks gestation with/without bronchopulmonary dysplasia (BPD).

Study design: Preterm infants < 29 weeks' gestation born 2007-2018 in New South Wales and the Australian Capital Territory, Australia, were included. Infants who died < 36 weeks' postmenstrual age and those with major congenital anomalies were excluded. Subjects were assessed at 18-42 months corrected age using the Bayley Scales of Infant Development, 3rd edition.

Results: 1436 infants without BPD (non-BPD) and 1189 infants with BPD were followed. The BPD group, 69 % infants were discharged without respiratory support (BPD1), 29 % on oxygen (BPD2) and 2 % on pressure support/tracheostomy (BPD3). Moderate neurodevelopmental impairment (NDI) was evident in 5.7 % of non-BPD infants, 11 % BPD1, 15 % BPD2, 15 % BPD3 infants. Severe NDI was seen in 1.7 % non-BPD infants, 3.4 % BPD1, 7.3 % BPD2, 35 % BPD3 infants. After adjusting for confounders, infants with BPD2 (OR 2.24, 99.9 % CI 1.25 to 5.77) or BPD3 (OR 5.99, 99.9 % CI 1.27 to 46.77) were more likely to have moderate-severe NDI compared to non-BPD infants.

Conclusion: The majority of infants with BPD were discharged home without respiratory support and had better neurocognitive outcomes in early childhood compared to those that required home-based oxygen or respiratory support.

Keywords: Bronchopulmonary dysplasia; Chronic neonatal lung disease; Neurodevelopmental outcomes; Non-invasive ventilation; Prematurity.

Publication types

Review