Neurodevelopmental Outcomes of Preterm Infants Born <29 Weeks with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Multicenter Study

Soumya R Thomas; Sunil K Jain; Prashanth Murthy; Chacko J Joseph; Amuchou Soraisham; Selphee Tang; Aliyah Dosani; Abhay Lodha

doi:10.1055/a-2121-8878

Neurodevelopmental Outcomes of Preterm Infants Born <29 Weeks with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Multicenter Study

Am J Perinatol. 2023 Jul 29. doi: 10.1055/a-2121-8878. Online ahead of print.

Authors

Soumya R Thomas^{1

2}, Sunil K Jain³, Prashanth Murthy^{1

2}, Chacko J Joseph^{1

2}, Amuchou Soraisham^{1

2

4}, Selphee Tang², Aliyah Dosani^{5

6}, Abhay Lodha^{1

2

4

6}

Affiliations

¹ Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
² Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada.
³ Division of Neonatology, Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas.
⁴ Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
⁵ School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada.
⁶ Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

PMID: 37399847
DOI: 10.1055/a-2121-8878

Abstract

Objective: This study aimed to determine neurodevelopmental outcomes of preterm infants born at <29 weeks' gestational age (GA) with bronchopulmonary dysplasia and pulmonary hypertension (BPD-PH) at 18 to 24 months' corrected age (CA).

Study design: In this retrospective cohort study, preterm infants born at <29 weeks' GA between January 2016 and December 2019, admitted to level 3 neonatal intensive care units, who developed BPD and were evaluated at 18 to 24 months' CA in the neonatal follow-up clinics were included. We compared demographic characteristics and neurodevelopmental outcomes between the two groups: Group I: BPD with PH and Group II: BPD with no PH, using univariate and multivariate regression models. The primary outcome was a composite of death or neurodevelopmental impairment (NDI). NDI was defined as any Bayley-III score < 85 on one or more of the cognitive, motor, or language composite scores.

Results: Of 366 eligible infants, 116 (Group I [BPD-PH] =7, Group II [BPD with no PH] = 109) were lost to follow-up. Of the remaining 250 infants, 51 in Group I and 199 in Group II were followed at 18 to 24 months' CA. Group I and Group II had median (interquartile range [IQR]) birthweights of 705 (325) and 815 g (317; p = 0.003) and median GAs (IQR) were 25 (2) and 26 weeks (2; p = 0.015) respectively. Infants in the BPD-PH group (Group I) were more likely to have mortality or NDI (adjusted odds ratio: 3.82; bootstrap 95% confidence interval; 1.44-40.87).

Conclusion: BPD-PH in infants born at <29 weeks' GA is associated with increased odds of the composite outcome of death or NDI at 18 to 24 months' CA.

Key points: · Long-term neurodevelopmental follow-up of preterm infants born <29 weeks' GA.. · Association of neurodevelopmental outcomes with BPD-associated PH.. · Need for longitudinal follow-up of children with BPD-associated PH..