Association between bronchopulmonary dysplasia and death or neurodevelopmental impairment at 3 years in preterm infants without severe brain injury

Wenli Li; Yong Wang; Juan Song; Chen Zhang; Yiran Xu; Falin Xu; Xiaoyang Wang; Changlian Zhu

doi:10.3389/fneur.2023.1292372

Association between bronchopulmonary dysplasia and death or neurodevelopmental impairment at 3 years in preterm infants without severe brain injury

Front Neurol. 2023 Nov 15:14:1292372. doi: 10.3389/fneur.2023.1292372. eCollection 2023.

Authors

Wenli Li^#^{1

2}, Yong Wang^#^{1

2}, Juan Song^#^{1

2}, Chen Zhang^{1

2}, Yiran Xu¹, Falin Xu^{1

2}, Xiaoyang Wang^{1

3}, Changlian Zhu^{1

4

5}

Affiliations

¹ Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience, Zhengzhou University, Zhengzhou, China.
² Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³ Center for Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
⁵ Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden.

^# Contributed equally.

Abstract

Objective: We investigated the association between bronchopulmonary dysplasia (BPD) and 3 years death or neurodevelopmental impairment (NDI) in very preterm infants without severe brain injury.

Method: Our prospective cohort study recruited preterm infants who were born prior to 32 weeks of gestational age and survived in the neonatal intensive care unit until 36 weeks of corrected age. Upon reaching 3 years of age, each infant was assessed for death or NDI such as cerebral palsy, cognitive deficit, hearing loss, and blindness. Correlations between BPD and death or NDI were determined using multiple logistic regression analyses adjusted for confounding factors.

Result: A total of 1,417 infants without severe brain injury who survived until 36 weeks of corrected age were initially enrolled in the study. Over the study period, 201 infants were lost to follow-up and 5 infants were excluded. Our final dataset, therefore, included 1,211 infants, of which 17 died after 36 weeks of corrected age and 1,194 were followed up to 3 years of age. Among these infants, 337 (27.8%) developed BPD. Interestingly, by 3 years of age, BPD was demonstrated to be independently associated with death or NDI, with an adjusted odds ratio of 1.935 (95% confidence interval: 1.292-2.899, p = 0.001), in preterm infants without severe neonatal brain injury.

Conclusion: Our findings indicate that BPD is strongly associated with death or NDI in preterm infants without severe neonatal brain injury at 3 years of age. Further research is needed to understand the mechanisms linking the development of BPD with death or NDI and whether appropriate treatment of BPD may ameliorate or prevent the development of neurological complications.

Keywords: brain injury; bronchopulmonary dysplasia; neurodevelopmental impairment; neurological disability; preterm infant.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Key Research and Development Program from the Ministry of Science and Technology of the People’s Republic of China (2022YFC2704801), the National Natural Science Foundation of China (U21A20347), the Swedish Research Council (2022-01019), Swedish Governmental grants to scientists working in health care (ALFGBG-965197), and a grant of the Henan Medical Science and Technique Foundation (LHGJ20190350 and SBGJ202301009).