Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.
Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
Early Hum Dev. 2021 Jan;152:105275. doi: 10.1016/j.earlhumdev.2020.105275. Epub 2020 Nov 16.
Bronchopulmonary dysplasia is a chronic respiratory disease that still affects preterm neonates; its association with neurodevelopmental (ND) impairment is already known. Different studies investigated neurodevelopmental outcomes in infants with BPD, often using the old dichotomous definition (BPD vs Non-BPD). This retrospective study aims to evaluate the role of different BPD severity grades on ND outcomes at 24 months of corrected age (CA).
All preterm infants born between 2011 and 2015 in the study hospital with a gestational age (GA) ≤ 30 weeks and discharged from our NICU were included and were divided in infants with and without BPD. Infants with BPD were divided into three severity groups as defined by NICHD/NHLBI Workshop in 2001, and were compared to their Non-BPD peers, matching them according to the same GA and year of birth. At 24 months postmenstrual age, we assessed general outcomes (growth and hospital readmissions) and neurodevelopmental outcomes (motor, developmental and sensory outcomes) with a standardized assessment.
We enrolled 89 patients affected by BPD of different grades of severity and a control group of 89 preterm infants without BPD. Infants with Moderate and Severe BPD showed a significantly higher corrected odds ratio (OR) for cognitive impairment compared to controls. Within the group of infants without severe disability (regarding Griffiths' scales), infants with Moderate and Severe BPD as well as infants with Mild BPD showed a significantly higher risk of a lower total Developmental Quotient (DQ) score, even after correction for confounding factors.
Our study evidenced that not only Severe BPD infants, but also Moderate ones showed a higher risk of overall cognitive impairment at 24 months CA. Within the group of infants without severe disability, also those with Mild BPD had lower Griffiths DQ scores than those without. This would suggest that infants with BPD, regardless of severity, warrant neurodevelopmental follow-up.
支气管肺发育不良（BPD）是一种影响早产儿的慢性呼吸系统疾病，其与神经发育（ND）损害的关联已被广泛认知。不同的研究已经调查了患有 BPD 的婴儿的神经发育结果，通常使用旧的二分法定义（BPD 与非 BPD）。本回顾性研究旨在评估不同 BPD 严重程度分级对校正胎龄（CA）24 个月时 ND 结果的影响。
纳入了在研究医院出生的所有胎龄（GA）≤30 周并从新生儿重症监护病房出院的 2011 年至 2015 年间的早产儿，并根据是否患有 BPD 进行分组。患有 BPD 的婴儿根据 2001 年 NICHD/NHLBI 研讨会的定义分为三组，并与非 BPD 婴儿进行比较，通过相同的 GA 和出生年份进行匹配。在 24 个月的校正月龄后，我们使用标准化评估来评估一般结局（生长和再次住院）和神经发育结局（运动、发育和感觉结局）。
我们纳入了 89 名患有不同严重程度 BPD 的患儿和 89 名没有 BPD 的早产儿作为对照组。患有中重度 BPD 的婴儿与对照组相比，认知障碍的校正比值比（OR）显著更高。在没有严重残疾（根据 Griffiths 量表）的婴儿中，患有中重度 BPD 以及患有轻度 BPD 的婴儿，即使在纠正了混杂因素后，其总的发育商（DQ）评分较低的风险也显著更高。
我们的研究表明，不仅重度 BPD 婴儿，而且中度 BPD 婴儿在 24 个月 CA 时也有更高的整体认知障碍风险。在没有严重残疾的婴儿中，即使是轻度 BPD 婴儿的 Griffiths DQ 评分也低于没有 BPD 的婴儿。这表明，无论严重程度如何，患有 BPD 的婴儿都需要进行神经发育随访。
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