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Neurodevelopment and healthcare utilisation at age 5–6 years in bronchopulmonary dysplasia: an EPIPAGE-2 cohort study
  1. Ludovic Tréluyer1,2,
  2. Alexandra Nuytten3,4,
  3. Isabelle Guellec5,
  4. Pierre-Henri Jarreau1,2,
  5. Valérie Benhammou1,
  6. Gilles Cambonie6,
  7. Patrick Truffert3,4,
  8. Laetitia Marchand-Martin1,
  9. Pierre Yves Ancel1,7,
  10. Héloïse Torchin1,2
  1. 1 Epidemiology and Statistics Research Center/CRESS, INSERM, INRAE, Paris Cité University, Paris, France
  2. 2 Department of Neonatal Medicine of Port-Royal, Cochin Hospital, FHU PREMA, AP-HP Centre, Université Paris Cité, Paris, France
  3. 3 CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France
  4. 4 CHU Lille, ULR 2694—METRICS: Évaluation des technologies de santé et des pratiques médicales, University of Lille, Lille, France
  5. 5 Department of Neonatal Medecine, University Hospital of Nice, Nice, France
  6. 6 Department of Neonatal Medicine, Montpellier University Hospital, Montpellier, France
  7. 7 Clinical Research Unit, Center for Clinical Investigation P1419, Assistance Publique Hôpitaux de Paris, F-75014, Paris, France
  1. Correspondence to Dr Ludovic Tréluyer, Inserm Equipe EPOPé, CRESS - Université Paris Cité / Site Villemin, Paris 75010, France; ludovic.treluyer{at}


Objective We aimed to study neurodevelopmental outcomes and healthcare utilisation at age 5–6 years in very preterm children with bronchopulmonary dysplasia (BPD).

Design Prospective and national population-based study.

Setting All the neonatal units in 25 French regions (21 of the 22 metropolitan regions and 4 overseas regions).

Patients Children born before 32 weeks’ gestation in 2011.

Interventions Blind, comprehensive and standardised assessment by trained neuropsychologists and paediatricians at age 5–6 years.

Main outcome measures Overall neurodevelopmental disabilities, behavioural difficulties, developmental coordination disorders, full-scale IQ, cerebral palsy, social interaction disorders, rehospitalisation in the previous 12 months and detailed developmental support.

Results Of the 3186 children included, 413 (11.7%) had BPD. The median gestational age of children with BPD was 27 weeks (IQR 26.0–28.0) and without BPD was 30 weeks (28.0–31.0). At age 5–6 years, 3150 children were alive; 1914 (60.8%) had a complete assessment. BPD was strongly associated with mild, moderate and severe overall neurodevelopmental disabilities (OR 1.49, 95% CI 1.05 to 2.20; 2.20, 1.41 to 3.42 and 2.71, 1.67 to 4.40). BPD was associated with developmental coordination disorders, behavioural difficulties, lower IQ score as well as rehospitalisation in the last 12 months and developmental support. The association between BPD and cerebral palsy was statistically significant before adjustment but not in adjusted analyses.

Conclusions BPD was strongly and independently associated with many neurodevelopmental disabilities. Improving medical and neurodevelopmental management of BPD in very preterm children should be a priority to reduce its long-term consequences.

  • neonatology
  • child development
  • epidemiology

Data availability statement

Data may be obtained from a third party and are not publicly available. The study protocol, the data access charter and the data access procedure can be found on the EPIPAGE-2 website ( Questionnaires and data catalogues are available on (

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Data availability statement

Data may be obtained from a third party and are not publicly available. The study protocol, the data access charter and the data access procedure can be found on the EPIPAGE-2 website ( Questionnaires and data catalogues are available on (

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  • Contributors Acquisition of data: PYA, VB, LM-M. Study concept, analysis and interpretation of data: LT, PYA, HT. Drafting of the manuscript: LT. Critical revision of the manuscript: all authors. Supervision: HT, PYA. Guarantor: PYA.

  • Funding LT benefited during this work from an annual research grant from AstraZeneca awarded by a jury of the French Society of Neonatology. The other authors received no additional funding. The EPIPAGE 2 project was funded with support from: (1) The French Institute of Public Health Research/Institute of Public Health and its partners: the French Health Ministry, the National Institute of Health and Medical Research (INSERM), the National Institute of Cancer and the National Solidarity Fund for Autonomy (CNSA); (2) The National Research Agency through the French EQUIPEX programme of investments in the future (reference ANR-11-EQPX-0038 and ANR-19-COHO-001); (3) The PREMUP Foundation; (4) Fondation de France (Reference 11779); (5) Fondation pour la Recherche Médicale (SPF20160936356); (6) Programme Hospitalier de Recherche Clinique Epinutri (DGOS13-040); (7) Ministère de l'Enseignement Supérieur, De La Recherche et de L'Innovation (G13129KK); (8) Apicil Foundation (R20065KK).

  • Disclaimer The funding organisations had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript and decision to submit the manuscript for publication.

  • Competing interests None declared.

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

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