Need for supplemental oxygen at discharge in infants with bronchopulmonary dysplasia is not associated with worse neurodevelopmental outcomes at 3 years corrected age

PLoS One. 2014 Mar 19;9(3):e90843. doi: 10.1371/journal.pone.0090843. eCollection 2014.

Abstract

Objectives: To 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 design: Longitudinal cohort study.

Setting: Southern Alberta regional center located at high altitude.

Participants: Preterm infants weighing ≤1250 grams with no BPD, BPD, and BPD with chronic oxygen dependency.

Main outcome measures: Neurodevelopmental and growth outcomes.

Results: Of 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)].

Conclusions: BPD 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchopulmonary Dysplasia / complications
  • Bronchopulmonary Dysplasia / physiopathology*
  • Bronchopulmonary Dysplasia / therapy
  • Child, Preschool
  • Developmental Disabilities / etiology
  • Developmental Disabilities / physiopathology*
  • Developmental Disabilities / therapy
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight
  • Longitudinal Studies
  • Male
  • Oxygen / pharmacology*
  • Patient Discharge
  • Respiration, Artificial
  • Respiratory Insufficiency / complications
  • Respiratory Insufficiency / physiopathology*
  • Respiratory Insufficiency / therapy

Substances

  • Oxygen

Grant support

This work was supported by the University of Calgary and Department of Pediatrics. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.