Epidemiology and Statistics Research Center/CRESS, INSERM, INRAE, Paris Cité University, Paris, France
Department of Neonatal Medicine of Port-Royal, Cochin Hospital, FHU PREMA, AP-HP Centre, Université Paris Cité, Paris, France.
Arch Dis Child Fetal Neonatal Ed. 2023 Dec 15;109(1):26-33. doi: 10.1136/archdischild-2023-325376.
We aimed to study neurodevelopmental outcomes and healthcare utilisation at age 5-6 years in very preterm children with bronchopulmonary dysplasia (BPD).
Prospective and national population-based study.
All the neonatal units in 25 French regions (21 of the 22 metropolitan regions and 4 overseas regions).
Children born before 32 weeks' gestation in 2011.
Blind, comprehensive and standardised assessment by trained neuropsychologists and paediatricians at age 5-6 years.
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.
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.
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.
研究患有支气管肺发育不良（BPD）的极早产儿在 5-6 岁时的神经发育结局和医疗保健利用情况。
前瞻性、全国性的基于人群的研究。
法国 25 个地区的所有新生儿病房（22 个大都市区中的 21 个和 4 个海外地区）。
2011 年出生于妊娠 32 周前的儿童。
由经过培训的神经心理学家和儿科医生在 5-6 岁时进行盲法、全面和标准化评估。
整体神经发育障碍、行为困难、发育协调障碍、全量表智商、脑瘫、社会互动障碍、前 12 个月再住院和详细的发育支持。
在纳入的 3186 名儿童中，413 名（11.7%）患有 BPD。患有 BPD 的儿童的中位胎龄为 27 周（IQR 26.0-28.0），而没有 BPD 的儿童的胎龄为 30 周（28.0-31.0）。在 5-6 岁时，3150 名儿童存活；1914 名（60.8%）完成了全面评估。BPD 与轻度、中度和重度整体神经发育障碍强烈相关（OR 1.49，95%CI 1.05-2.20；2.20，1.41-3.42 和 2.71，1.67-4.40）。BPD 与发育协调障碍、行为困难、智商得分较低以及前 12 个月的再住院和发育支持有关。BPD 与脑瘫之间的关联在调整前有统计学意义，但在调整分析中没有。
BPD 与许多神经发育障碍强烈且独立相关。改善极早产儿的 BPD 的医疗和神经发育管理应该是优先事项，以减少其长期后果。
