Abstract
ObjectivesTo determine if chronic oxygen dependency (discharge home on supplemental oxygen) in children with bronchopulmonary dysplasia (BPD; defined as requirement for supplemental O2 at 36 weeks postmenstrual age) predicts neurodevelopmental disability rates and growth outcomes at 36 months corrected age (CA).Study DesignLongitudinal cohort study.SettingSouthern Alberta regional center located at high altitude.ParticipantsPreterm infants weighing ≤1250 grams with no BPD, BPD, and BPD with chronic oxygen dependency.Main outcome measuresNeurodevelopmental and growth outcomes.ResultsOf 1563 preterm infants admitted from 1995–2007, 1212 survived. Complete follow-up data were available for 1030 (85%) children. Children in BPD and BPD with chronic oxygen dependency groups had significantly lower birth weights, gestational ages, prolonged mechanical ventilation and oxygen supplementation and received more postnatal steroids, compared to those without BPD. Children with BPD and BPD with chronic oxygen dependency were more likely to be below the 5th centile in weight and height compared to those without BPD but there was little difference between the BPD and BPD with chronic oxygen dependency groups. After controlling for confounding variables, children who had BPD and BPD with chronic oxygen dependency had higher odds of neurodevelopmental disability compared to those without BPD [OR (odds ratio) 1.9 (95%CI 1.1 to 3.5) and OR 1.8 (1.1 to 2.9), respectively], with no significant difference between BPD and BPD with chronic oxygen dependency [OR 0.9 (95% CI 0.6 to 1.5)].ConclusionsBPD and BPD with chronic oxygen dependency in children predicts abnormal neurodevelopmental outcomes at 36 months CA. However, the neurodevelopmental disability rates were not significantly higher in BPD with chronic oxygen dependency children compared to children with BPD only. Compared to those without BPD, growth is impaired in children with BPD and BPD with chronic oxygen dependency, but no difference between the latter two groups.
Highlights
Bronchopulmonary dysplasia (BPD) is a common and serious problem in very preterm infants
After controlling for confounding variables, children who had BPD and BPD with chronic oxygen dependency had higher odds of neurodevelopmental disability compared to those without BPD [odds ratio (OR) 1.9 (95%CI 1.1 to 3.5) and OR 1.8 (1.1 to 2.9), respectively], with no significant difference between BPD and BPD with chronic oxygen dependency [OR 0.9]
The neurodevelopmental disability rates were not significantly higher in BPD with chronic oxygen dependency children compared to children with BPD only
Summary
Bronchopulmonary dysplasia (BPD) is a common and serious problem in very preterm infants. It is characterized by early lung injury and can progress to severe BPD [1]. Shannon et al [4] defined BPD based on oxygen dependency at 36 weeks postmenstrual age (PMA) as opposed to Northway’s definition [5] of BPD based on oxygen requirement at 28 days of life. This change in definition based on longer duration of oxygen requirement has had an impact on predicting preterm infants’ long term neurodevelopmental outcomes. The purpose of home oxygen therapy is to prevent the effects of hypoxemia and to prevent pulmonary and bronchial vasoconstriction leading to alteration in the airway causing obstruction and impairment in growth of pulmonary and ocular vasculature and their effects on long term neurodevelopmental outcomes [3,7,8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
