Department of Neonatology, Amsterdam University Medical Centers, Emma Children's Hospital, Amsterdam, The Netherlands,
Amsterdam Reproduction and Development, Amsterdam, The Netherlands,
Neonatology. 2024;121(1):125-132. doi: 10.1159/000533653. Epub 2023 Oct 18.
The objective of this study was to identify risk factors for neurodevelopmental impairment (NDI) at 2- and 5-years corrected age (CA) in a cohort of preterm infants with established bronchopulmonary dysplasia (BPD).
This single-center retrospective cohort study included infants born between 2009 and 2016 at a gestational age (GA) <30 weeks with moderate or severe BPD at 36 weeks' postmenstrual age. Perinatal characteristics, (social) demographics, and comorbidities were collected from the electronic patient records. Odds ratios for NDI were calculated with univariate and multivariate logistic regression analyses adjusting for potential confounders.
Of the 602 eligible infants, 123 infants were diagnosed with BPD. NDI was present in 30.3% and 56.1% at 2- and 5-years CA, respectively. The only independent risk factors associated with NDI in the multivariate analyses were birthweight (adjusted odds ratio [aOR] 0.74, 95% CI 0.57-0.95; aOR 0.70, 95% CI 0.54-0.91, respectively), small for GA (SGA) (aOR 3.25, 95% CI 1.09-9.61; aOR 5.44, 95% CI 1.62-18.2, respectively) at both time points, and male gender at 5-years CA (OR 2.49, 95% CI 1.11-5.57).
Birthweight and SGA are independent risk factors for NDI at 2- and 5-years CA and male gender at 5-years CA in preterm infants with BPD. In contrast, well-known other risk factors for NDI in the general population of preterm infants, such as GA, maternal education, and neonatal comorbidities were not independently associated with NDI.
本研究的目的是确定患有已确诊支气管肺发育不良（BPD）的早产儿队列在 2 岁和 5 岁校正年龄（CA）时发生神经发育障碍（NDI）的风险因素。
这项单中心回顾性队列研究纳入了 2009 年至 2016 年间出生的、GA<30 周且在 36 周龄时患有中重度 BPD 的婴儿。从电子病历中收集围产期特征、（社会）人口统计学和合并症数据。使用单变量和多变量逻辑回归分析计算 NDI 的比值比（OR），并对潜在混杂因素进行调整。
在 602 名符合条件的婴儿中，有 123 名婴儿被诊断为 BPD。分别有 30.3%和 56.1%的婴儿在 2 岁和 5 岁 CA 时存在 NDI。多变量分析中与 NDI 相关的唯一独立危险因素是出生体重（调整后的 OR [aOR] 0.74，95% CI 0.57-0.95；aOR 0.70，95% CI 0.54-0.91）、两个时间点的小胎龄儿（SGA）（aOR 3.25，95% CI 1.09-9.61；aOR 5.44，95% CI 1.62-18.2）和 5 岁 CA 时的男性性别（OR 2.49，95% CI 1.11-5.57）。
在患有 BPD 的早产儿中，出生体重和 SGA 是 2 岁和 5 岁 CA 时发生 NDI 的独立危险因素，而在 5 岁 CA 时男性性别是 NDI 的独立危险因素。相比之下，GA、母亲教育和新生儿合并症等在早产儿一般人群中与 NDI 相关的其他已知危险因素与 NDI 无独立相关性。
