Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Children's Hospital of Philadelphia-Roberts Center for Pediatric Research, Philadelphia, Pennsylvania, USA.
Pediatr Pulmonol. 2021 Nov;56(11):3509-3517. doi: 10.1002/ppul.25381. Epub 2021 Apr 12.
Preterm infants with bronchopulmonary dysplasia (BPD), and particularly those who develop the most severe forms of chronic lung disease during the neonatal period, are at high risk for poor developmental outcomes throughout childhood. Infants who require mechanical ventilation at 36 weeks post-menstrual age have significantly increased odds for cerebral palsy, developmental delay at 2 years, and poor academic achievement and low intelligence quotient in adolescence. Over the past several decades, many therapies and care strategies, including steroids, continuous positive airway pressure, surfactant, and other medications have been introduced into clinical practice. These approaches have changed the epidemiology of BPD in very preterm infants. However, BPD remains common and strongly associated with poor development throughout childhood. Only caffeine has been proven to reduce BPD and improve childhood developmental outcomes. In future research, it will be essential to better understand the developmental sequelae of BPD beyond school age and to test interventions to improve developmental trajectories in this population. As new management strategies for BPD are developed, it will be essential to rigorously evaluate both short-term and long-term effects before they are introduced into routine neonatal practice.
患有支气管肺发育不良（BPD）的早产儿，尤其是在新生儿期发展为最严重形式的慢性肺部疾病的早产儿，在整个儿童期都存在发育不良的高风险。在孕龄 36 周后需要机械通气的婴儿，脑瘫、2 岁时发育迟缓以及青春期学业成绩不佳和智商低下的几率显著增加。在过去的几十年中，许多治疗方法和护理策略，包括类固醇、持续气道正压通气、表面活性剂和其他药物，已被引入临床实践。这些方法改变了极早产儿 BPD 的流行病学。然而，BPD 仍然很常见，并与整个儿童期的发育不良密切相关。只有咖啡因已被证明可降低 BPD 并改善儿童发育结局。在未来的研究中，必须更好地了解 BPD 的发育后遗症，超出学龄期，并测试改善该人群发育轨迹的干预措施。随着新的 BPD 管理策略的发展，在将其引入常规新生儿实践之前，必须严格评估其短期和长期效果。
