Developmental sequelae in preterm infants having a diagnosis of bronchopulmonary dysplasia
Developmental sequelae in preterm infants having a diagnosis of bronchopulmonary dysplasia
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DOI：
10.1001/archpedi.161.11.1082
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发表时间：
2007-11-01
影响因子：
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通讯作者：
Singer, Lynn T.
中科院分区：
文献类型：
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作者：
Short, Elizabeth J.;Kirchner, Lester;Singer, Lynn T.
目的：研究3岁和8岁时支气管肺发育不良（BPD）的严重程度定义、治疗选择和神经认知结果之间的关系。设计：这是对99名有BPD病史的儿童前瞻性纵向样本收集的数据进行的二次分析。1989年2月1日至1991年11月31日在3所医院住院的BPD患儿99例。三个严重程度组根据胎龄和是否需要补充氧疗分为轻度、中度和重度三组。主要暴露：补充氧疗28天或更长时间，出生体重小于1500 g，以及肺部疾病的放射学证据。主要结果测量：神经学和医学结果;医学管理类型;比较3个严重程度组的语言、成绩和认知功能。结果：BPD的严重程度分级与不良结局相关。与轻度或中度BPD儿童相比，重度BPD儿童在3岁时的智商测试（智力发展指数，90 vs 76.4;心理发展指数，92.5 vs 73.9）和语言测量（总，95 vs 82）以及8岁时的操作智商（86 vs 75）和知觉组织（86 vs 76）表现更差。BPD的严重程度与医疗管理的选择无关，但与教育干预有关。重度BPD儿童比轻度BPD儿童接受更多的特殊教育服务（69%对44%）。结论：基于严重程度的分类阐明了BPD和发育后遗症之间的关系。与轻度或中度BPD儿童相比，重度BPD儿童在8岁时需要更多的干预。
Objective: To investigate the relationship between the severity- based definition of bronchopulmonary dysplasia ( BPD), choice of treatment, and neurocognitive outcomes at age 3 and 8 years.Design: This is a secondary analysis of data collected from a prospective, longitudinal sample of 99 children with a history of BPD.Setting: Children born with BPD admitted to 3 hospitals from February 1, 1989, to November 31, 1991.Participants: Ninety- nine children with BPD were longitudinally assessed at age 3 and 8 years. Three severity groups ( mild, moderate, and severe) were formed based on gestational age and need for supplemental oxygen therapy.Main Exposures: Supplemental oxygen therapy for 28 days or longer, birth weight less than 1500 g, and radiographic evidence of lung disease.Main Outcome Measures: Neurologic and medical outcomes; type of medical management; and language, achievement, and cognitive functioning were compared among the 3 severity groups. Results: Severity classification of BPD was associated with poorer outcomes. Compared with children with mild or moderate BPD, children with severe BPD performed more poorly on IQ tests ( Mental Development Index, 90 vs 76.4; and Psychomotor Development Index, 92.5 vs 73.9) and language measures ( total, 95 vs 82) at age 3 years and performance IQ ( 86 vs 75) and perceptual organization ( 86 vs 76) at age 8 years. Severity of BPD was not associated with choice of medical management but was related to educational interventions. Children with severe BPD received more special education services ( 69% vs 44%) than did children with mild BPD.Conclusions: The severity- based classification clarifies the relationship between BPD and developmental sequelae. Children with severe BPD required more interventions at age 8 years than did children with mild or moderate BPD.