THREE YEAR OUTCOME OF INFANTS WITH BRONCHOPULMONARY DYSPLASIA (BPD) AND VERY LOW BIRTHWEIGHT. † 1666

Abstract

In a regional cohort, we investigated the relationship of BPD, relative to other perinatal risk factors, to developmental outcome at 3 years. Infants with BPD (n=122), VLBW without BPD (84), and term (T) infants (123) were given the Bayley Scales at 3 years. Groups did not differ in sex, race, SES, age. Drug exposed infants were excluded. BPD infants had more perinatal risk factors, i.e. lower GA, BW, more IVH, neurologic problems, sepsis and ROP,(p's <.05). Both mental (84 ± 24 v. 90 ± 16 v. 96 ± 12), and motor (84 ± 29 v. 98 ± 20 v. 103 ± 15, p's<.001) scores were lower for BPD children. Using multiple regression controlling for all other risk factors, BPD had an independent negative effect on motor outcome (p <.02), with neurologic risk and BPD the only significant predictors of motor delay, accounting for 25% (p <.001) of the variance. In contrast, social class, race and neurologic risk were the only significant predictors of cognitive outcome. The effect of SES on cognitive outcome was evident in differential rates of mental retardation within the BPD group. In the lowest SES group (IV-V) 26% of children were thus classified, vs. 14% in the middle/high SES group (I-III). This rate contrasts with 19% of VLBW infants thus classified in the lowest SES group vs. 2% in the middle/high SES groups, and 7% of term, low SES children vs. 3% of middle/high SES children. These findings suggest that the effects of BPD are primarily on the motor domain, and demonstrate the importance of postnatal factors and intervention on cognitive outcome. (HL38193, MCJ 390592).