Neurodevelopmental outcomes in very preterm infants: The role of severity of Bronchopulmonary Dysplasia

Gallini, Francesca; Coppola, Maria Gabriella; Rose, Domenico Umberto De; Maggio, Luca; Arena, Roberta; Romano, Valerio; Cota, Francesco; Ricci, Daniela; Romeo, Domenico M.; Mercuri, Eugenio; Vento, Giovanni

doi:10.1016/j.earlhumdev.2020.105275

Cited by 34 publications

(24 citation statements)

References 51 publications

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“…From those that did use a severity-based BPD diagnosis, Ehrenkranz et al reported that increased severity of BPD in a cohort of infants born between 1995-1998 was associated with increased risk of neurodevelopmental J o u r n a l P r e -p r o o f impairment (NDI) at 18-22 months CA (5). smaller studies including infants born between 2009-2015, however, showed conflicting results (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…Two cohort studies also assessed the association between the severity of BPD and NDI at two years CA (15,16). Both studies did not find any association between BPD severity and the two year CA developmental outcome after correction for confounders (15), except for the subdomain composite cognitive score in the moderate and severe BPD group in one study (16). Both studies had a relatively small sample size and a high rate of children who were lost to follow up, which may explain the discrepancy with our results.…”

Section: Discussionmentioning

confidence: 99%

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Severity of Bronchopulmonary Dysplasia and Neurodevelopmental Outcome at 2 and 5 Years Corrected Age

Katz

Vliegenthart

Aarnoudse-Moens

et al. 2022

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Severity of Bronchopulmonary Dysplasia and Neurodevelopmental Outcome at 2 and 5 Years Corrected Age

Katz

Vliegenthart

Aarnoudse-Moens

et al. 2022

The Journal of Pediatrics

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“…Preterm infants may also experience intermittent HI after birth, due to conditions such as apnea of prematurity causing repeated periods of mild hypoxia, which are associated with neurodevelopmental and motor impairment [15]. Further, preterm infants may develop bronchopulmonary dysplasia (BPD), a chronic respiratory disease that is associated with frequent periods of hypoxia and neurodevelopmental impairment, particularly if it is moderate or severe [16].…”

Section: Brain Injury Associated With Hypoxia-ischemiamentioning

confidence: 99%

Preventing Brain Injury in the Preterm Infant—Current Controversies and Potential Therapies

Yates

Gunn

Bennet

et al. 2021

IJMS

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Preterm birth is associated with a high risk of morbidity and mortality including brain damage and cerebral palsy. The development of brain injury in the preterm infant may be influenced by many factors including perinatal asphyxia, infection/inflammation, chronic hypoxia and exposure to treatments such as mechanical ventilation and corticosteroids. There are currently very limited treatment options available. In clinical trials, magnesium sulfate has been associated with a small, significant reduction in the risk of cerebral palsy and gross motor dysfunction in early childhood but no effect on the combined outcome of death or disability, and longer-term follow up to date has not shown improved neurological outcomes in school-age children. Recombinant erythropoietin has shown neuroprotective potential in preclinical studies but two large randomized trials, in extremely preterm infants, of treatment started within 24 or 48 h of birth showed no effect on the risk of severe neurodevelopmental impairment or death at 2 years of age. Preclinical studies have highlighted a number of promising neuroprotective treatments, such as therapeutic hypothermia, melatonin, human amnion epithelial cells, umbilical cord blood and vitamin D supplementation, which may be useful at reducing brain damage in preterm infants. Moreover, refinements of clinical care of preterm infants have the potential to influence later neurological outcomes, including the administration of antenatal and postnatal corticosteroids and more accurate identification and targeted treatment of seizures.

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“…Moreover, brain ultrasounds were performed up to term, even after discharge, according to our Neonatal High-Risk Follow-up program. 40 Future studies may investigate if nutritional practices and neurodevelopmental outcomes could be improved according to serial B-GREAT assessments, considering that higher protein and caloric intakes could have a positive effect on the growth of brain volumes. 41…”

Section: Discussionmentioning

confidence: 99%

Brain Growth Evaluation Assessed with Transfontanellar (B-GREAT) Ultrasound. Old and New Bedside Markers to Estimate Cerebral Growth in Preterm Infants: a Pilot Study

et al. 2021

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Objective: We aimed to investigate the feasibility of evaluating overall preterm brain growth using a gathered set of measurements of brain structures in standard cranial ultrasound planes. We called this method of assessment Brain GRowth Evaluation Assessed with Transfontanellar ultrasound (B-GREAT). Study design: In this prospective observational cohort study, cranial ultrasound was regularly performed (on day 1, 2, 3, 7 of life and then weekly until discharge and at term) in preterm infants born with a gestational age less than 32 weeks. We evaluated Corpus Callosum (CC) length, Corpus Callosum-Fastigium (CCF) length, Anterior Horn Width (AHW), Frontal White Matter (FWM) height, Total brain Surface (TBS), Deep Grey Matter (DGM) height, Hemisphere Height (HH), Transverse Cerebellar Diameter in the axial view (TCDax) and coronal view (TCDcor). Measurements obtained were used to develop growth charts for B-GREAT markers as a function of postmenstrual age. Reproducibility of B-GREAT markers was studied. Results: A total of 528 cranial ultrasounds was performed in 80 neonates (median birth gestational age: 28+5 weeks, interquartile range: 27+3 to 30+5). The intraclass correlation coefficients for intra-observer and inter-observer analyses showed substantial agreement for all B-GREAT markers. Growth curves for B-GREAT markers were developed. Conclusion: B-GREAT is a feasible and reproducible method for bedside monitoring of the growth of the main brain structures in preterm neonates.

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Neurodevelopmental outcomes in very preterm infants: The role of severity of Bronchopulmonary Dysplasia

Cited by 34 publications

References 51 publications

Severity of Bronchopulmonary Dysplasia and Neurodevelopmental Outcome at 2 and 5 Years Corrected Age

Severity of Bronchopulmonary Dysplasia and Neurodevelopmental Outcome at 2 and 5 Years Corrected Age

Preventing Brain Injury in the Preterm Infant—Current Controversies and Potential Therapies

Brain Growth Evaluation Assessed with Transfontanellar (B-GREAT) Ultrasound. Old and New Bedside Markers to Estimate Cerebral Growth in Preterm Infants: a Pilot Study

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