Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition

Girija Natarajan; Athina Pappas; Seetha Shankaran; Douglas E Kendrick; Abhik Das; Rosemary D Higgins; Abbot R Laptook; Edward F Bell; Barbara J Stoll; Nancy Newman; Ellen C Hale; Rebecca Bara; Michele C Walsh

doi:10.1016/j.earlhumdev.2011.12.013

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Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition

Journal article

Peer reviewed

Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition

Girija Natarajan, Athina Pappas, Seetha Shankaran, Douglas E Kendrick, Abhik Das, Rosemary D Higgins, Abbot R Laptook, Edward F Bell, Barbara J Stoll, Nancy Newman, …

Early human development, Vol.88(7), pp.509-515

07/2012

DOI: 10.1016/j.earlhumdev.2011.12.013

PMCID: PMC3686277

PMID: 22236557

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https://www.ncbi.nlm.nih.gov/pmc/articles/3686277View

Open Access

Abstract

We compared neurodevelopmental outcomes of extremely low birth weight (ELBW) infants with and without bronchopulmonary dysplasia (BPD), using the physiologic definition. ELBW (birth weights<1000 g) infants admitted to the Neonatal Research Network centers and hospitalized at 36 weeks postmenstrual age (n=1189) were classified using the physiologic definition of BPD. Infants underwent Bayley III assessment at 18-22 months corrected age. Multivariable logistic regression was used to determine the association between physiologic BPD and cognitive impairment (score<70). BPD by the physiologic definition was diagnosed in 603 (52%) infants, 537 of whom were mechanically ventilated or on FiO(2)>30% and 66 who failed the room air challenge. Infants on room air (n=505) and those who passed the room air challenge (n=51) were classified as "no BPD" (n=556). At follow up, infants with BPD had significantly lower mean weight and head circumference. Moderate to severe cerebral palsy (7 vs. 2.1%) and spastic diplegia (7.8 vs. 4.1%) and quadriplegia (3.9 vs. 0.9%) phenotypes as well as cognitive (12.8 vs. 4.6%) and language scores<70 (24.2 vs. 12.3%) were significantly more frequent in those with BPD compared to those without BPD. BPD was independently associated (adjusted OR 2.4; 95% CI 1.40-4.13) with cognitive impairment. Rates of adverse neurodevelopmental outcomes in early childhood were significantly higher in those with BPD. BPD by the physiologic definition was independently associated with cognitive impairment using Bayley Scales III. These findings have implications for targeted post-discharge surveillance and early intervention.

Algorithms

Infant, Newborn, Diseases - physiopathology

Prognosis

Follow-Up Studies

Infant, Newborn, Diseases - diagnosis

Humans

Terminology as Topic

Male

Treatment Outcome

Bronchopulmonary Dysplasia - physiopathology

Educational Status

Infant, Newborn, Diseases - therapy

Gestational Age

Infant, Newborn, Diseases - classification

Young Adult

Bronchopulmonary Dysplasia - diagnosis

Bronchopulmonary Dysplasia - therapy

Early Medical Intervention

Adult

Female

Bronchopulmonary Dysplasia - classification

Infant, Extremely Low Birth Weight - physiology

Infant, Newborn

Details

Title: Subtitle: Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition
Creators: Girija Natarajan - Department of Pediatrics, Wayne State University, Detroit, MI, USA. gnatara@med.wayne.edu
Athina Pappas
Seetha Shankaran
Douglas E Kendrick
Abhik Das
Rosemary D Higgins
Abbot R Laptook
Edward F Bell
Barbara J Stoll
Nancy Newman - Case Western Reserve University
Ellen C Hale
Rebecca Bara
Michele C Walsh
Resource Type: Journal article
Publication Details: Early human development, Vol.88(7), pp.509-515
DOI: 10.1016/j.earlhumdev.2011.12.013
PMID: 22236557
PMCID: PMC3686277
NLM abbreviation: Early Hum Dev
ISSN: 0378-3782
eISSN: 1872-6232
Grant note: M01 RR80 / NCRR NIH HHS U10 HD021385-16 / NICHD NIH HHS U10 HD27856 / NICHD NIH HHS M01 RR997 / NCRR NIH HHS M01 RR59 / NCRR NIH HHS U10 HD34216 / NICHD NIH HHS U10 HD27851 / NICHD NIH HHS U10 HD53089 / NICHD NIH HHS U10 HD027904-12 / NICHD NIH HHS M01 RR125 / NCRR NIH HHS U10 HD27880 / NICHD NIH HHS U10 HD27904 / NICHD NIH HHS M01 RR39 / NCRR NIH HHS M01 RR32 / NCRR NIH HHS M01 RR7122 / NCRR NIH HHS U10 HD27853 / NICHD NIH HHS U10 HD21364 / NICHD NIH HHS M01 RR70 / NCRR NIH HHS U10 HD36790 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS M01 RR8084 / NCRR NIH HHS U10 HD40498 / NICHD NIH HHS U10 HD27871 / NICHD NIH HHS UL1 TR000454 / NCATS NIH HHS U10 HD40689 / NICHD NIH HHS M01 RR44 / NCRR NIH HHS U10 HD40461 / NICHD NIH HHS U10 HD21385 / NICHD NIH HHS UL1 RR24139 / NCRR NIH HHS M01 RR633 / NCRR NIH HHS M01 RR750 / NCRR NIH HHS U10 HD40521 / NICHD NIH HHS U10HD53109 / NICHD NIH HHS U10 HD40492 / NICHD NIH HHS U10 HD21373 / NICHD NIH HHS U10 HD021385 / NICHD NIH HHS M01 RR30 / NCRR NIH HHS M01 RR54 / NCRR NIH HHS U10 HD53119 / NICHD NIH HHS
Language: English
Date published: 07/2012
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093333102771

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