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Original research
Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks
  1. Monika Martin1,
  2. Lynne Smith1,
  3. Julie A Hofheimer2,
  4. Elisabeth C McGowan3,4,
  5. T Michael O'Shea2,
  6. Steve Pastyrnak5,
  7. Brian Scott Carter6,
  8. Jennifer Helderman7,
  9. Jennifer Check7,
  10. Charles Neal8,
  11. Mary B Roberts9,
  12. Lynne M Dansereau4,10,
  13. Sheri A Della Grotta4,10,
  14. Barry M Lester3,4,10,11
  1. 1 Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, USA
  2. 2 Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
  3. 3 Department of Pediatrics, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  4. 4 Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
  5. 5 Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA
  6. 6 Department of Pediatrics-Neonatology, Children's Mercy Hospital, Kansas City, Missouri, USA
  7. 7 Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
  8. 8 Department of Pediatrics, University of Hawai'i at Mānoa John A Burns School of Medicine, Honolulu, Hawaii, USA
  9. 9 Center for Primary Care and Prevention, Care New England Health System, Providence, Rhode Island, USA
  10. 10 Brown Center for the Study of Children at Risk, Providence, Rhode Island, USA
  11. 11 Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  1. Correspondence to Dr Lynne Smith, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, USA; smith{at}lundquist.org

Abstract

Objective To identify neurobehavioural risks in preterm infants with bronchopulmonary dysplasia (BPD) prior to hospital discharge.

Design and patients Longitudinal study of 676 newborns born before 30 weeks of gestation.

Setting Nine university NICUs affiliated with six universities. All were Vermont Oxford Network (VON) participants.

Patients and interventions Infants were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study from April 2014 to June 2016. Prospective medical record reviews, VON definitions and criteria, and maternal interviews were used to collect maternal and neonatal medical variables and socioenvironmental data.

Main Outcome Measures NICU Network Neurobehavioral Scale (NNNS) at the time of hospital discharge; Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) and Gross Motor Function Classification System at 2 years’ corrected age.

Results Infants with moderate/severe BPD were less attentive (Wald χ2 9.68, p=0.008), more lethargic (Wald χ2 9.91, p=0.007), with increased non-optimal reflexes (Wald χ2 7.37, p=0.025). Infants with moderate/severe BPD were more likely to have Bayley-III language and motor scores <85 (adjusted OR (aOR) 1.74, 95% CI 1.06 to 2.85, and aOR 2.06, 95% CI 1.10 to 3.85). Infants with both moderate/severe and mild BPD were more likely to have a cerebral palsy diagnosis (aOR 2.96, 95% CI 1.34 to 6.54, and aOR 2.81, 95% CI 1.32 to 5.99).

Conclusions BPD severity presents risks for poor neurodevelopment at NICU discharge and at age 2 years. Early identification of poorly regulated behaviour can provide critical information for early preventive and targeted interventions with potential to improve long-term outcomes.

  • child health
  • infant development
  • neonatology
  • paediatrics
  • child development

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not Applicable.

https://doi.org/10.1136/archdischild-2021-323405

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. Not Applicable.

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    Footnotes

    • Contributors MM was responsible for the conceptualisation, investigation and resources of the article as well as the drafting and editing of the manuscript. LS was responsible for the conceptualisation, data curation, investigation and supervision of the article, along with the drafting and editing of the article. JAH was responsible for the conceptualisation, methodology, investigation, supervision, funding acquisition, data curation and resources of the article, along with the drafting and editing of the article. ECM, SP, BCS, JH, JC and CN were responsible for the methodology, investigation and resources of the article, along with the editing of the article. LMD and MBR were responsible for the methodology, data curation, formal analysis and resources of the article, as well as the drafting and editing of the article. SADG was responsible for the methodology, investigation, data curation and resources of the article, along with the editing of the article. TMOS and BML were responsible for the conceptualisation, methodology, investigation, supervision, funding acquisition, data curation and resources of the article, along with the drafting and editing of the article. BML is the guarantor.

    • Funding This study was funded by the National Institutes of Health/Eunice Kennedy Shriver National Institute of Child Health & Human Development (grant number R01HD072267).

    • Disclaimer The study sponsors had no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; nor the decision to submit the paper for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.