The impact of early tracheostomy on neurodevelopmental outcomes of infants with severe bronchopulmonary dysplasia exposed to postnatal corticosteroids

Amjad Taha; Gangaram Akangire; Janelle Noel-Macdonnell; Tiffany Gladdis; Winston Manimtim

doi:10.1038/s41372-023-01864-5

The impact of early tracheostomy on neurodevelopmental outcomes of infants with severe bronchopulmonary dysplasia exposed to postnatal corticosteroids

J Perinatol. 2023 Dec 29. doi: 10.1038/s41372-023-01864-5. Online ahead of print.

Authors

Amjad Taha^{1

2}, Gangaram Akangire^{3

4}, Janelle Noel-Macdonnell^{2

5}, Tiffany Gladdis^{1

6}, Winston Manimtim^{1

2}

Affiliations

¹ Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA.
² Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
³ Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA. gakangire@cmh.edu.
⁴ Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. gakangire@cmh.edu.
⁵ Department of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA.
⁶ Department of Developmental and Behavioral Health, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.

PMID: 38158399
DOI: 10.1038/s41372-023-01864-5

Abstract

Objective: To compare the cognitive, language and motor scores of infants with severe BPD exposed to postnatal corticosteroids (PCS) and had early (ET), late (LT) or no tracheostomy (NT).

Methods: Retrospective study was designed to compare the developmental outcomes of 71 infants born between 2010 and 2017 with severe BPD exposed to PCS and had ET (≤122 days), LT (>122 days), or NT.

Results: Cognitive scores were lower in LT versus NT and ET (p = 0.050); motor scores were worse in LT versus NT and ET (p = 0.004). Dexamethasone use was higher in LT versus NT and ET (p = 0.040). Adjusted for PCS, odds for major cognitive impairment were 90% less in ET versus LT. Trend for improved language and motor outcomes was seen in ET versus LT.

Conclusion: Infants with severe BPD exposed to PCS and had ET had significantly better cognitive, and trend toward improved language and motor outcomes.