[Health status at the age of 5-7 years of preterm infants with and without bronchopulmonary dysplasia].
OBJECTIVE
Bronchopulmonary dysplasia (BPD) is one of the most common late complications of prematurity. The study aimed to evaluate: 1) somatic development, 2) psychomotor development, 3) parental opinion of health status of the child and 4) prevalence of bronchial hyperreactivity among 5-7 years old children with history of BPD.


METHODS
Case-control study included 56 newborns born < or =32 weeks of gestation with mean birthweight (SD) 1057+/-218g. BPD was defined as at least 28 days of oxygen therapy and oxygen or positive pressure support at 36 weeks postmenstrual age. The control group consisted of newborns matched by sex, birthweight (+/-100g), gestational age (+/-1 weeks) and year of hospitalization. Somatic and psychomotor developments were prospectively evaluated up to age of 5-7 years. Parents were asked to complete two questionnaires: one assessing normal daily activity of the child and the standardized questionnaire used by International Study of Asthma and Allergies In Childhood (ISAAC). Peak expiratory flow rates (PEFR) before and after the inhalation of betamimetic were evaluated.


RESULTS
No significant difference in somatic development was found between the study group and the control group. Normal psychomotor development was diagnosed in 11 (39%) children with BPD and in 13(46%) children without BPD. Mild or moderate impairment was diagnosed in 12 (43%) cases and 13 (36%) controls, and severe impairment in 5 (18%) and 2 (7%) children. At the age of 5-7 years children with BPD presented lower IQ as compared to children without BPD (94+/-25 vs. 103+/-16, p= 0.2). Parents of children with BPD more often declared that their child's development is impaired (39% vs. 11%, OR: 4.96; 95%CI: 1.2-20). Wheezing in past history was noted in 18 cases (64%) and only in 10 (35%) children without BPD (OR: 3.24; 95% CI: 1.09-9.67). Mean PEFR did not differ significantly between the studied groups (80.5+/-16.3% vs 84.5+/-15.4%; p=0.4). Moreover, changes of PEFR after a dose of betamimetic were similar in both groups (21% vs. 19%, p=0.7).


CONCLUSIONS
The intellectual development of children with BPD at the age of 5-7 is worse than in the control group, especially as declared by their parents. Episodes of wheezing in infancy occurred more frequently in the group of children with BPD. However, bronchial hyperreactivity at the age of 5-7 is not significantly more frequent.
Kwinta
Przemko
P
Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medium w Krakowie. kwintap@mp.pl
Tomasik
Tomasz
T
Klimek
Małgorzata
M
Cichocka-Jarosz
Ewa
E
Lis
Grzegorz
G
Pietrzyk
Jacek J
JJ
D000203:Activities of Daily Living; D016535:Bronchial Hyperreactivity / Q000453:epidemiology; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology* / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D011597:Psychomotor Performance; D012135:Respiratory Sounds; D011795:Surveys and Questionnaires