Valleur-Masson D, Vodovar M, Zeller J, Laudat F, Masson Y, Kassis M, Nobre R, Kochert F, Voyer M
Centre d'Action Médico-Sociale Précoce, l'Institut de Puériculture de Paris IPP.
Arch Fr Pediatr. 1993 Aug-Sep;50(7):553-9.
The survival and outcome of infants with bronchopulmonary dysplasia (BD) depend on the patient's maturity, the severity of the BD and nutritional problems. This study evaluates the specific role of chronic pulmonary failure in the growth and development of infants recovering from BD.
88 infants admitted for BD from January 1984 to December 1988, having gestational age from 25 to 41 weeks 5 days (mean: 29) and birth weight from 680 to 3,400 g (mean: 1,195) were studied. All infants were given respiratory support for 6 to 914 days (mean 84) and oxygen therapy for 28 to 1,232 days (mean: 119). 29 infants were given corticosteroids for more than 1 month. The outcome of the 80 infants with gestational ages of less than 33 weeks was compared to that of 272 infants with the same gestational age but not suffering from BD on their 28th day. The infants in both groups were examined at 2 years of age and classified as: a) handicapped (neurologic deficit, IQ < 80, hearing loss, blindness, convulsions); b) doubtful (transitory neurology dysfunction); c) normal.
Of the 88 infants still living at the age of 28 days, 19 died before the age of 2 years: 16 of the 64 surviving infants who could be followed until the age of 2 years were classified as handicapped, 13 were considered doubtful and 35 were normal. The more significant risk factors for neurodevelopmental impairment were: a) the presence of porencephaly and/or ventricular dilatation on brain ultrasonography; b) head circumference < -2 SD at the end of hospital stay; c) oxygen therapy and hospitalization > 5-6 months. The group of infants with BD had a higher death rate (24% vs. 3.7 in the group without BD) and more frequent neurodevelopmental impairment at gestational ages of > 31-32 weeks.
BD is an extra risk for the survival and neurodevelopment of infants with gestational age > 31 weeks.
支气管肺发育不良（BD）婴儿的生存及预后取决于患儿的成熟度、BD的严重程度以及营养问题。本研究评估慢性肺功能衰竭在从BD恢复的婴儿生长发育中的具体作用。
研究了1984年1月至1988年12月因BD入院的88名婴儿，其孕周为25至41周5天（平均29周），出生体重为680至3400克（平均1195克）。所有婴儿接受呼吸支持6至914天（平均84天），吸氧治疗28至1232天（平均119天）。29名婴儿接受皮质类固醇治疗超过1个月。将80名孕周小于33周的BD婴儿的结局与272名相同孕周但未患BD的婴儿在第28天的结局进行比较。两组婴儿在2岁时接受检查并分类为：a）残疾（神经缺陷、智商<80、听力丧失、失明、惊厥）；b）可疑（短暂性神经功能障碍）；c）正常。
88名在28天时仍存活的婴儿中，19名在2岁前死亡：64名存活且能随访至2岁的婴儿中，16名被分类为残疾，13名被认为可疑，35名正常。神经发育受损的更显著危险因素为：a）脑超声检查显示存在脑穿通畸形和/或脑室扩张；b）住院期末头围<-2标准差；c）吸氧治疗和住院>5至6个月。BD婴儿组死亡率更高（24% vs. 无BD组的3.7%），在孕周>31至32周时神经发育受损更频繁。
BD是孕周>31周婴儿生存及神经发育的额外风险因素。
