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Am J Perinatol 2024; 41(S 01): e2505-e2513
DOI: 10.1055/a-2121-8878
Original Article

Neurodevelopmental Outcomes of Preterm Infants Born <29 Weeks with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Multicenter Study

Soumya R. Thomas
1   Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
2   Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
,
Sunil K. Jain
3   Division of Neonatology, Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
,
Prashanth Murthy
1   Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
2   Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
,
Chacko J. Joseph
1   Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
2   Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
,
Amuchou Soraisham
1   Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
2   Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
4   Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
,
Selphee Tang
2   Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
,
Aliyah Dosani
5   School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
6   Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
,
Abhay Lodha
1   Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
2   Neonatal Follow-up Clinic, Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
4   Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
6   Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
› Author Affiliations
Funding No funding was received for the completion of this study. S.R.T. received travel grant from the Alberta Children's' Hospital Research Institute to present the abstract of this study's findings at the Pediatric Academy Society meeting in April 2022, at Denver, Colorado, USA.
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Abstract

Objective This study aimed to determine neurodevelopmental outcomes of preterm infants born at <29 weeks' gestational age (GA) with bronchopulmonary dysplasia and pulmonary hypertension (BPD–PH) at 18 to 24 months' corrected age (CA).

Study Design In this retrospective cohort study, preterm infants born at <29 weeks' GA between January 2016 and December 2019, admitted to level 3 neonatal intensive care units, who developed BPD and were evaluated at 18 to 24 months' CA in the neonatal follow-up clinics were included. We compared demographic characteristics and neurodevelopmental outcomes between the two groups: Group I: BPD with PH and Group II: BPD with no PH, using univariate and multivariate regression models. The primary outcome was a composite of death or neurodevelopmental impairment (NDI). NDI was defined as any Bayley-III score < 85 on one or more of the cognitive, motor, or language composite scores.

Results Of 366 eligible infants, 116 (Group I [BPD–PH] =7, Group II [BPD with no PH] = 109) were lost to follow-up. Of the remaining 250 infants, 51 in Group I and 199 in Group II were followed at 18 to 24 months' CA. Group I and Group II had median (interquartile range [IQR]) birthweights of 705 (325) and 815 g (317; p = 0.003) and median GAs (IQR) were 25 (2) and 26 weeks (2; p = 0.015) respectively. Infants in the BPD–PH group (Group I) were more likely to have mortality or NDI (adjusted odds ratio: 3.82; bootstrap 95% confidence interval; 1.44–40.87).

Conclusion BPD–PH in infants born at <29 weeks' GA is associated with increased odds of the composite outcome of death or NDI at 18 to 24 months' CA.

Key Points

  • Long-term neurodevelopmental follow-up of preterm infants born <29 weeks' GA.

  • Association of neurodevelopmental outcomes with BPD-associated PH.

  • Need for longitudinal follow-up of children with BPD-associated PH.

Keywords

preterm infants - bronchopulmonary dysplasia - pulmonary hypertension - neurodevelopmental outcomes

Note

This project was previously presented at the Pediatric Academy Society meeting in April 2022 at Denver, CO.


Ethical Approval

The study was approved by the Conjoint Health Research Ethics Board of the University of Calgary and the UTMB Institutional Review Board, and the need for consent was waived as the study used deidentified data.


Authors' Contributions

All the authors have contributed to the study design, data acquisition, interpretation of results, reviewing the manuscript, and approval of the final version.




Publication History

Received: 31 January 2023

Accepted: 30 June 2023

Accepted Manuscript online:
03 July 2023

Article published online:
29 July 2023

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