Effects Of Bronchopulmonary Dysplasia Research Articles

Systematic review and meta-analysis: the effect of bronchopulmonary dysplasia on neurodevelopment in very low birth weight premature infants.

BackgroundA meta-analysis was performed to study the effect of steroid intervention on the neurodevelopment of extremely low birth weight preterm infants complicated with bronchopulmonary dysplasia, and to provide a theoretical basis for clinical treatment.MethodsThe Wanfang database, Chinese Biomedical Literature database, VIP database, Baidu Academic, CNKI database, The Cochrane Library, Medline, Embase, and PubMed database were searched by computer from establishment to 2021. Randomized controlled trials on the effect of steroids on neurodevelopment in very low birth weight preterm infants with bronchial dysplasia published from January 10, 2007 were retrieved. The included literature was evaluated for bias risk, then analyzed using RevMan 5.3 software.ResultsA total of 9 studies were included, with a total of 2,453 patients. The funnel plot showed that the circles and the midline of some studies were basically symmetrical, and there was no bias in the publications. The conclusions obtained were relatively reliable. Cerebral palsy, neurodevelopmental indicators, and MRI findings of preterm infants were analyzed. The cognitive impairment of very low birth weight preterm infants complicated with bronchial dysplasia (RR =0.83, 95% CI: 0.72–0.96, P=0.01) in the treatment group was significantly different from that in the control group, while cerebral palsy (RR =0.99, 95% CI: 0.75–1.29, P=0.93), speech impairment (RR =0.75, 95% CI: 0.46–1.21, P=0.24), hearing loss requiring amplification (RR =0.60, 95% CI: 0.35–1.03, P=0.06), bilateral blindness RR =0.81, 95% CI: 0.52–1.24, P=0.32), severe intraventricular hemorrhage (IVH) (RR =0.71, 95% CI: 0.33–1.50, P=0.37), and cystic periventricular leukomalacia (RR =0.82, 95% CI: 0.43–1.57, P=0.56) had no significant differences compared with the control group.DiscussionIn this meta-analysis, we found that the use of steroids in very low birth weight preterm infants complicated with bronchial dysplasia had significant effects on cognition, but no significant effects on hearing, vision, or language function.

A clinical analysis of neurobehavioral development within one year after birth in preterm infants with bronchopulmonary dysplasia

To study the effect of bronchopulmonary dysplasia (BPD) on neurobehavioral development within one year after birth in preterm infants. A retrospective analysis was performed for the preterm infants with a gestational age of <34 weeks who were born from September 2017 to December 2019 and completed the follow-up assessments of neurobehavioral development at the corrected gestational ages of 40 weeks and 3, 6, and 12 months. According to their diagnosis, they were divided into a BPD group with 23 infants and a non-BPD group with 27 infants. The outcome of neurobehavioral development was compared between the two groups at different time points. There was no significant difference in the neonatal behavioral neurological assessment score between the BPD and non-BPD groups at the corrected gestational age of 40 weeks (P>0.05). Based on the Gesell Developmental Scale, compared with the non-BPD group, the BPD group had significantly lower global developmental quotient (DQ) and DQs of fine motor, adaptive behavior, and personal-social behavior at the corrected gestational ages of 3, 6, and 12 months (P<0.05). For both groups, the DQ of language at the corrected gestational age of 6 months was significantly higher than that at the corrected gestational age of 12 months (P<0.017), the DQ of personal-social behavior at the corrected gestational age of 6 months was significantly higher than that at the corrected gestational age of 3 months (P<0.017), and the DQ of adaptive behavior at the corrected gestational age of 12 months was significantly higher than that at the corrected gestational ages of 3 and 6 months (P<0.017). Based on the BSID-II scale, there were no significant differences in mental development index and psychomotor development index at each time point between the two groups (P>0.05). The mental development index at the corrected gestational age of 3 months was significantly higher than that at the corrected gestational ages of 6 and 12 months in both groups (P<0.001). Preterm infants with BPD have delayed neurodevelopment within one year after birth compared with those without BPD, which should be taken seriously in clinical practice.

Sleep disordered breathing in bronchopulmonary dysplasia.

There are limited data on the effect of bronchopulmonary dysplasia (BPD) on sleep disordered breathing (SDB). We hypothesized that both the severity of prematurity and BPD would increase the likelihood of SDB in early childhood. Our secondary aim was to evaluate the association of demographic factors on the development of SDB. This is a retrospective study of patient factors and overnight polysomnogram (PSG) data of children enrolled in our BPD registry between 2008 and 2015. Association between PSG results and studied variables was assessed using multiple linear regression analysis. One-hundred-forty children underwent at least one sleep study on room air. The mean respiratory disturbance index (RDI) was elevated at 9.9 events/hr (SD: 10.1). The mean obstructive apnea-hypopnea index (OAHI) was 6.5 (9.1) events/hr and the mean central event rate of 3.0 (3.7) events/hr. RDI had decreased by 22% or 1.5 events/hour (95%CI: 0.6, 1.9) with each year of age (P = 0.005). Subjects with more severe respiratory disease had 38% more central events (P = 0.02). Infants exposed to secondhand smoke had 2.4% lower (P = 0.04) oxygen saturation nadirs and a pattern for more desaturation events. Non-white subjects were found to have 33% higher OAHI (P = 0.05), while white subjects had a 61% higher rate of central events (P < 0.001). RDI was elevated in a selected BPD population compared to norms for non-preterm children. BPD severity, smoke exposure, and race may augment the severity of SDB. RDI improved with age but was still elevated by age 4, suggesting that this population is at risk for the sequelae of SDB.

118. Neonatal cortical auditory evoked potentials are affected by bronchopulmonary dysplasia occurring in early prematurity

Bronchopulmonary dysplasia, the most frequent respiratory sequelae of prematurity, usually occurs as part of the multiorgan foetal inflammatory response syndrome. The underlying mechanism is thought to be the same cytokine mediated leukemoid reaction associated with periventricular leukomalacia of premature infants. Event-related potentials have been shown to serve as early indicators of problems in cortical development. Our aim was to determine the effect of bronchopulmonary dysplasia on neonatal cortical auditory processing. Forty-five premature infants (23–34 weeks) were recorded at 35 post-conceptional weeks. Infants with genetic syndromes, clinical evidence of neonatal encephalopathy, intra-ventricular haemorrhage or periventricular leukomalacia were not recruited. The average of 330 responses to 1000 Hz pure tones (inter-stimulus interval 1250–1850 ms), were recorded at frontal location. Mean amplitudes calculated from the data points of 30 ms centered on P1 and N2 peaks in the waveforms of each subject were measured. The amplitude of P1 component resulted lower in infants with bronchopulmonary dysplasia (p = .004). Results show an association between bronchopulmonary dysplasia and alterations in brain auditory processing, even in absence of major neurological risk factors. This further support the hypothesis of an interference with brain development mediated by the foetal inflammatory response syndrome.

258 Fetal Haemoglobin Levels in Preterm Infants at 36 Weeks Postmenstrual Age: Effect of Bronchopulmonary Dysplasia, Sepsis and Transfusions

Background and AimsPrevious studies showed that switchover from fetal (HbF) to adult (HbA) haemoglobin occurs in relation to postmenstrual age (PMA).AimsTo assess HbF levels at 36 weeks PMA in preterm...

Population pharmacokinetics of aminophylline in Korean preterm infants using TDM data

Background/Aims To investigate demographic and clinical covariates that influence aminophylline clearance in Korean neonatal population, especially the effect of bronchopulmonary dysplasia (BPD) on aminophylline pharmacokinetics. Methods For 34 Korean neonate patients (26 boys and 8 girls), blood samples were drawn at the steady-state of plasma concentration after multiple infusions of the drug, with only one sample per each patient. Patients' demographic characteristics were 55.9± 60.0 days for postnatal age, 38.2± 10.2 weeks for corrected age based on the gestational period, and 2.31±1.73 kg for weight at analysis (mean± standard deviation). Aminophylline concentration was analyzed by Fluorescence Polarization Immunoassay. The clearance and covariate effects (sex, age, serum creatinine, or disease (apnea vs BPD)) were estimated by a nonlinear mixed effect model using the NONMEM software. Results Aminophylline clearance was significantly influenced by both corrected age (p <<< 0.0001) and postnatal age (p << 0.0001) and was also influenced by serum creatinine (p <0.0001). However, no significant effects were found for sex and disease. Conclusion Our results suggest that aminophylline clearance in Korean neonatal patients is less influenced by the presence of BPD, rather affected by the age that is closely related to the renal development. However, our data also suggest that the results may be biased with a relatively small number of subjects and other possible confounding factors. Clinical Pharmacology & Therapeutics (2005) 77, P86–P86; doi: 10.1016/j.clpt.2004.12.221

Early Postnatal Growth in Bronchopulmonary Dysplasia 228

Background: The effect of bronchopulmonary dysplasia (BPD) on early postnatal growth is not well documented. Subjects: 26 premature babies (8M,16F; mean birth weight 1014 (695-1590)g; median gestational age 27(24-31) weeks). 13 infants had BPD diagnosed by oxygen dependency and radiological abnormalities at 28 days. 4 received dexamethasone(D) for a median time of 27 days. Measurements: Daily weight (g), weekly occipital-frontal circumference (OFC)(cm) and total body length(TBL)(cm) during the first 5-8 weeks of life. Caloric and protein intakes were calculated. Results: Caloric and protein intakes were similiar in babies with and without BPD (111.5 vs 116.0 kcals/kg/day; 2.38 vs 2.51 g/kg/day). Conclusions: Growth is attenuated in babies receiving D for BPD. Growth in normal and non-D treated babies with BPD is similiar. Given adequate nutrition, BPD per se does not appear to compromise early post natal growth. Table

Mother to Child: First Living Donor Lung Transplant

IN THE LATEST example of the lengths to which a mother will go in hopes of saving the life of a terminally ill child, 45-year-old Versell Johnson of Salt Lake City, Utah, donated one third of her right lung to replace the entire right lung of her 12-year-old daughter, Mazie Bond. The child suffered from bronchopulmonary dysplasia but both mother and daughter are expected to resume normal activity within a few months, says Vaughn A. Starnes, MD, head of the heart-lung transplant program, Stanford (Calif) University Medical Center, who did the operation. Starnes is evaluating several more cases for possible living-donor transplantation. He estimates that several hundred children in the United States might benefit each year from a single lung transplant—from a live donor or a cadaver—to help them deal with the effects of bronchopulmonary dysplasia, pulmonary hypertension, and congenital diaphragmatic hernias. Starnes says the fact that children who receive