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
- child development
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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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.
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