Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition.
Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition.
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DOI：
10.1016/j.earlhumdev.2011.12.013
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发表时间：
2012-07
影响因子：
2.5
通讯作者：
Walsh, Michele C.
中科院分区：
文献类型：
--
作者：
Natarajan, Girija;Pappas, Athina;Shankaran, Seetha;Kendrick, Douglas E.;Das, Abhik;Higgins, Rosemary D.;Laptook, Abbot R.;Bell, Edward F.;Stoll, Barbara J.;Newman, Nancy;Hale, Ellen C.;Bara, Rebecca;Walsh, Michele C.
我们使用生理学定义比较了伴有和不伴有支气管肺发育不良（BPD）的极低出生体重儿（ELBW）的神经发育结果。新生儿研究网络中心收治的1,189例经后36周住院的ELBW（出生体重<1000 g）婴儿采用BPD的生理学定义进行分类。婴儿在矫正年龄18-22个月时接受Bayley III评估。采用多变量逻辑回归分析确定生理性BPD与认知功能障碍（评分< 70）之间的关系。603例（52%）婴儿被诊断为生理定义的BPD，其中537例接受机械通气或FiO 2> 30%，66例室内空气挑战失败。接受室内空气的婴儿（n=505）和通过室内空气挑战的婴儿（n=51）被归类为“无BPD”（n=556）。在随访时，BPD婴儿的平均体重和头围明显较低。中度至重度脑瘫（7 vs. 2.1%）和痉挛性双瘫（7.8 vs. 4.1%）和四肢瘫痪（3.9 vs. 0.9%）表型以及认知（12.8 vs. 4.6%）和语言评分< 70（24.2 vs. 12.3%）在BPD患者中的发生率显著高于无BPD患者。BPD与认知功能障碍独立相关（调整OR 2.4; 95% CI 1.40-4.13）。BPD儿童早期神经发育不良的发生率明显高于BPD儿童。生理定义的BPD与Bayley量表III的认知障碍独立相关。这些发现对有针对性的出院后监测和早期干预具有重要意义。
We compared neurodevelopmental outcomes of extremely low birth weight (ELBW) infants with and without bronchopulmonary dysplasia (BPD), using the physiologic definition. ELBW (birth weights <1000 grams) infants admitted to the Neonatal Research Network centers and hospitalized at 36 weeks postmenstrual age (n=1,189) were classified using the physiologic definition of BPD. Infants underwent Bayley III assessment at 18-22 months corrected age. Multivariable logistic regression was used to determine the association between physiologic BPD and cognitive impairment (score < 70). BPD by the physiologic definition was diagnosed in 603 (52%) infants, 537 of whom were mechanically ventilated or on FiO2 > 30% and 66 who failed the room air challenge. Infants on room air (n=505) and those who passed the room air challenge (n=51) were classified as “no BPD” (n=556). At follow up, infants with BPD had significantly lower mean weight and head circumference. Moderate to severe cerebral palsy (7 vs. 2.1%) and spastic diplegia (7.8 vs. 4.1%) and quadriplegia (3.9 vs. 0.9%) phenotypes as well as cognitive (12.8 vs. 4.6%) and language scores < 70 (24.2 vs. 12.3%) were significantly more frequent in those with BPD compared to those without BPD. BPD was independently associated (adjusted OR 2.4; 95% CI 1.40-4.13) with cognitive impairment. Rates of adverse neurodevelopmental outcomes in early childhood were significantly higher in those with BPD. BPD by the physiologic definition was independently associated with cognitive impairment using Bayley Scales III. These findings have implications for targeted post-discharge surveillance and early intervention.
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影响因子：
8
作者：
Hintz, SR;Kendrick, DE;Higgins, RD
通讯作者：
Higgins, RD
影响因子：
8
作者：
Laughon, Matthew;O'Shea, Michael T.;Leviton, Alan
通讯作者：
Leviton, Alan
影响因子：
8
作者：
Short, EJ;Klein, NK;Singer, LT
通讯作者：
Singer, LT
影响因子：
8
作者：
Stoll BJ;Hansen NI;Bell EF;Shankaran S;Laptook AR;Walsh MC;Hale EC;Newman NS;Schibler K;Carlo WA;Kennedy KA;Poindexter BB;Finer NN;Ehrenkranz RA;Duara S;Sánchez PJ;O'Shea TM;Goldberg RN;Van Meurs KP;Faix RG;Phelps DL;Frantz ID 3rd;Watterberg KL;Saha S;Das A;Higgins RD;Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
影响因子：
120.7
作者：
Schmidt, B;Asztalos, EV;Whitfield, MF
通讯作者：
Whitfield, MF