Developmental sequelae in preterm infants having a diagnosis of bronchopulmonary dysplasia: analysis using a severity-based classification system.
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.


METHODS
This is a secondary analysis of data collected from a prospective, longitudinal sample of 99 children with a history of BPD.


METHODS
Children born with BPD admitted to 3 hospitals from February 1, 1989, to November 31, 1991.


METHODS
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.


METHODS
Supplemental oxygen therapy for 28 days or longer, birth weight less than 1500 g, and radiographic evidence of lung disease.


METHODS
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.
Short
Elizabeth J
EJ
Department of Psychology, Case Western Reserve University, Cleveland, Ohio 44106, USA. Elizabeth.Short@case.edu
Kirchner
H Lester
HL
Asaad
George R
GR
Fulton
Sarah E
SE
Lewis
Barbara A
BA
Klein
Nancy
N
Eisengart
Sheri
S
Baley
Jill
J
Kercsmar
Carolyn
C
Min
Meeyoung O
MO
Singer
Lynn T
LT
D001997:Bronchopulmonary Dysplasia / Q000145:classification* / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007805:Language Development Disorders / Q000453:epidemiology; D008297:Male; D012720:Severity of Illness Index