The Children's Hospital at Westmead, Locked Bag 4001 Westmead, NSW, 2145, Australia.
The Children's Hospital at Westmead, Locked Bag 4001 Westmead, NSW, 2145, Australia; Discipline of Child and Adolescent Health, Children's Hospital at Westmead Clinical School, Faculty of Medicine, Discipline of Health Sciences, University of Sydney, NSW, Australia.
Paediatr Respir Rev. 2024 Jun;50:23-30. doi: 10.1016/j.prrv.2024.02.004. Epub 2024 Mar 1.
To investigate the neurodevelopmental outcomes for preterm infants born < 29 weeks gestation with/without bronchopulmonary dysplasia (BPD).
Preterm infants < 29 weeks' gestation born 2007-2018 in New South Wales and the Australian Capital Territory, Australia, were included. Infants who died < 36 weeks' postmenstrual age and those with major congenital anomalies were excluded. Subjects were assessed at 18-42 months corrected age using the Bayley Scales of Infant Development, 3rd edition.
1436 infants without BPD (non-BPD) and 1189 infants with BPD were followed. The BPD group, 69 % infants were discharged without respiratory support (BPD1), 29 % on oxygen (BPD2) and 2 % on pressure support/tracheostomy (BPD3). Moderate neurodevelopmental impairment (NDI) was evident in 5.7 % of non-BPD infants, 11 % BPD1, 15 % BPD2, 15 % BPD3 infants. Severe NDI was seen in 1.7 % non-BPD infants, 3.4 % BPD1, 7.3 % BPD2, 35 % BPD3 infants. After adjusting for confounders, infants with BPD2 (OR 2.24, 99.9 % CI 1.25 to 5.77) or BPD3 (OR 5.99, 99.9 % CI 1.27 to 46.77) were more likely to have moderate-severe NDI compared to non-BPD infants.
The majority of infants with BPD were discharged home without respiratory support and had better neurocognitive outcomes in early childhood compared to those that required home-based oxygen or respiratory support.
研究<29 周龄伴或不伴支气管肺发育不良（BPD）的早产儿的神经发育结局。
纳入 2007 年至 2018 年在澳大利亚新南威尔士州和首都领地出生的<29 周龄的早产儿。排除了<36 周龄校正胎龄死亡和患有重大先天性畸形的婴儿。采用贝利婴幼儿发育量表第三版对 18-42 个月龄校正年龄的受试者进行评估。
共随访了 1436 例无 BPD（非 BPD）婴儿和 1189 例有 BPD 婴儿。BPD 组中，69%的婴儿在未接受呼吸支持的情况下出院（BPD1），29%的婴儿需要吸氧（BPD2），2%的婴儿需要压力支持/气管切开术（BPD3）。非 BPD 婴儿中有 5.7%存在中度神经发育障碍（NDI），BPD1 婴儿中有 11%，BPD2 婴儿中有 15%，BPD3 婴儿中有 15%。非 BPD 婴儿中有 1.7%存在严重 NDI，BPD1 婴儿中有 3.4%，BPD2 婴儿中有 7.3%，BPD3 婴儿中有 35%。在调整了混杂因素后，与非 BPD 婴儿相比，BPD2（OR 2.24，99.9%CI 1.25 至 5.77）或 BPD3（OR 5.99，99.9%CI 1.27 至 46.77）患儿更有可能出现中重度 NDI。
与需要家庭氧疗或呼吸支持的婴儿相比，大多数 BPD 患儿在出院时无需呼吸支持，且在幼儿期神经认知结局更好。
