Cognitive performance of premature infants: association between bronchopulmonary dysplasia and cognitive skills. Cross-sectional study

Abstract

CONTEXT AND OBJECTIVE: Children born prematurely often have worse cognitive performance than those born at term regarding skills such as memory, attention and processing speed. Bronchopulmonary dysplasia may compromise cognitive development. The aims here were: a) To describe the cognitive performance of preterm infants with very low birth weight; b) To investigate its association with bronchopulmonary dysplasia adjusted for sociodemographic, neonatal and post-neonatal factors. DESIGN AND SETTING: Cross-sectional study developed in a public tertiary-care hospital. METHODS:To evaluate cognition among 112 children, we applied an intelligence scale (Wechsler scale). The average scores for children with and without bronchopulmonary dysplasia were compared across the five domains of the scale. Associations with bronchopulmonary dysplasia were investigated for domains that showed significant differences between the two groups. Associations between exposure and outcome were estimated via multivariate logistic regression. RESULTS: There were no differences in averages for the full-scale intelligence quotient, verbal intelligence quotient, performance intelligence quotient and general language composite domains. The processing speed quotient was the only domain that presented a significant difference between the two groups (P = 0.02). Among the children with bronchopulmonary dysplasia, low full-scale intelligence quotient was observed in 28.1%. In the multivariate analysis, bronchopulmonary dysplasia (odds ratio: 3.1; 95% confidence interval: 1.1-8.7) remained associated with the outcome of processing speed quotient. CONCLUSION: Bronchopulmonary dysplasia was an independent risk factor for alteration of the processing speed quotient.RESUMO CONTEXTO E OBJETIVO: Crianças nascidas prematuras com frequência apresentam pior desempenho cognitivo que as nascidas a termo em habilidades como memória, atenção, velocidade de processamento. A displasia broncopulmonar pode comprometer o desenvolvimento cognitivo. Os objetivos aqui foram: a) Descrever o desempenho cognitivo de crianças nascidas prematuras com muito baixo peso; b) Investigar sua associação com a displasia broncopulmonar ajustada para fatores sócio-demográficos, neonatais e pós-neonatais. TIPO DE ESTUDO E LOCAL: Estudo transversal desenvolvido em hospital público de cuidados terciários. MÉTODOS: Para a avaliação cognitiva de 112 crianças, aplicamos a escala de inteligência (Wechsler scale). Foram comparadas as médias dos escores das crianças com e sem displasia broncopulmonar nos cinco domínios da escala. A associação com a displasia broncopulmonar foi investigada para os domínios que apresentaram diferença significativa entre os dois grupos. A associação entre a exposição e o desfecho foi estimada por regressão logística multivariada. RESULTADOS: Não houve diferença entre as médias dos domínios do quociente de inteligência total, quociente de inteligência verbal, quociente de inteligência de execução e composto de linguagem geral. O quociente de velocidade de p...

Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia

“…Oxygen dependence for at least 28 days, historically a common definition for BPD, is imprecise for identifying children at risk for long‐term developmental sequelae. Studies utilizing this definition fail to identify associations with either cognitive impairment or cerebral palsy 25,26 . On the other hand, studies that utilize BPD definitions that require oxygen or respiratory support at 36 weeks PMA are more likely to identify significant associations 10,25 .…”