Katz TA, Vliegenthart RJS, Aarnoudse-Moens CSH, Leemhuis AG, Beuger S, Blok GJ, van Brakel MJM, van den Heuvel MEN, van Kempen AAMW, Lutterman C, Rijpert M, Schiering IA, Ran NC, Visser F, Wilms J, van Kaam AH, Onland W. Severity of Bronchopulmonary Dysplasia and Neurodevelopmental Outcome at 2 and 5 Years Corrected Age. J Pediatr. 2021 Dec 18:S0022-3476(21)01196-3. doi: 10.1016/j.jpeds.2021.12.018. Epub ahead of print. PMID: 34929243.
Abstract
Objective: To evaluate the association between bronchopulmonary dysplasia
(BPD) severity and risk of neurodevelopmental impairment (NDI) at 2 years and 5
years corrected age and to examine whether this association changes over time.
Study design: This single-center retrospective cohort study included patients
with a gestational age <30 weeks surviving to 36 weeks postmenstrual age,
divided into groups according to BPD severity. NDI was defined as having
cognitive or motor abilities below -1 SD, cerebral palsy, or a hearing or a
visual impairment. The association was assessed using a multivariate logistic
regression model analysis, adjusting for known confounders for NDI, and
mixed-model analysis.
Results: Of the 790 surviving infants (15% diagnosed with mild BPD, 9%
with moderate BPD, and 10% with severe BPD), 88% and 82% were longitudinally
assessed at 2 years and 5 years corrected age, respectively. The mixed-model
analysis showed a statistically significant increase in NDI at all levels of
BPD severity compared with infants with no BPD, and a 5-fold increased risk in
NDI was seen from 2 years to 5 years corrected age in all degrees of BPD
severity. The strength of this association between NDI and BPD severity did not
change over time.
Conclusions: Increased BPD severity is associated with increased risk of NDI
at both 2 years and 5 years corrected age. The absolute incidence of NDI
increased significantly from 2 years to 5 years corrected age for all BPD
severity categories, but this increased risk was similar at both time points in
each category.
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