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

Katz, Trixie A; Vliegenthart, Roos J. S.; Aarnoudse-Moens, Cornelieke S.H.; Wassenaer-Leemhuis, Aleid van; Beuger, Sabine; Blok, G.J.; Brakel, M.J.M. van; Heuvel, M.E.N. van den; Kempen, Anne A. M. W. van; Lutterman, Claire A. M.; Rijpert, Maarten; Schiering, Irene A. M.; Ran, Nicolien C.; Visser, Fay; Wilms, J. F.; Kaam, Anton H. van; Onland, Wes

doi:10.1016/j.jpeds.2021.12.018

Cited by 44 publications

(31 citation statements)

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“…These findings support the potential use of NNNS exam findings prescriptively in infants with BPD for preventive and targeted interventions. Our findings are consistent with previous findings of cognitive and motor impairments at 24 months associated with BPD severity 30 31…”

Section: Discussionsupporting

confidence: 93%

Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks

Martin

Smith

Hofheimer

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo identify neurobehavioural risks in preterm infants with bronchopulmonary dysplasia (BPD) prior to hospital discharge.Design and patientsLongitudinal study of 676 newborns born before 30 weeks of gestation.SettingNine university NICUs affiliated with six universities. All were Vermont Oxford Network (VON) participants.Patients and interventionsInfants were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study from April 2014 to June 2016. Prospective medical record reviews, VON definitions and criteria, and maternal interviews were used to collect maternal and neonatal medical variables and socioenvironmental data.Main Outcome MeasuresNICU Network Neurobehavioral Scale (NNNS) at the time of hospital discharge; Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) and Gross Motor Function Classification System at 2 years’ corrected age.ResultsInfants with moderate/severe BPD were less attentive (Wald χ2 9.68, p=0.008), more lethargic (Wald χ2 9.91, p=0.007), with increased non-optimal reflexes (Wald χ2 7.37, p=0.025). Infants with moderate/severe BPD were more likely to have Bayley-III language and motor scores <85 (adjusted OR (aOR) 1.74, 95% CI 1.06 to 2.85, and aOR 2.06, 95% CI 1.10 to 3.85). Infants with both moderate/severe and mild BPD were more likely to have a cerebral palsy diagnosis (aOR 2.96, 95% CI 1.34 to 6.54, and aOR 2.81, 95% CI 1.32 to 5.99).ConclusionsBPD severity presents risks for poor neurodevelopment at NICU discharge and at age 2 years. Early identification of poorly regulated behaviour can provide critical information for early preventive and targeted interventions with potential to improve long-term outcomes.

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Section: Discussionsupporting

confidence: 93%

Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks

Martin

Smith

Hofheimer

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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“…Moreover, increasing evidence has suggested that BPD is not merely a lung disease but a systemic condition with short-term and long-term multiple organ implications[ 3 , 5 ]. Clinical and experimental findings demonstrated that chronic exposure to hyperoxia causes oxidative stress and leads to certain implications, including neurodevelopmental impairments[ 6 ], retinopathy of prematurity[ 7 , 8 ], renal vascular and tubular development impairments[ 9 , 10 ], and associated cardiac disease[ 11 , 12 ]. Notably, hyperoxia exposure in neonates results in long-term cardiac defects and renal abnormalities in later adult life.…”

Section: Introductionmentioning

confidence: 99%

Intratracheal administration of umbilical cord-derived mesenchymal stem cells attenuates hyperoxia-induced multi-organ injury via heme oxygenase-1 and JAK/STAT pathways

Dong¹,

Zhou²,

Liu³

et al. 2022

WJSC

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BACKGROUND Bronchopulmonary dysplasia (BPD) is not merely a chronic lung disease, but a systemic condition with multiple organs implications predominantly associated with hyperoxia exposure. Despite advances in current management strategies, limited progress has been made in reducing the BPD-related systemic damage. Meanwhile, although the protective effects of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) or their exosomes on hyperoxia-induced lung injury have been explored by many researchers, the underlying mechanism has not been addressed in detail, and few studies have focused on the therapeutic effect on systemic multiple organ injury. AIM To investigate whether hUC-MSC intratracheal administration could attenuate hyperoxia-induced lung, heart, and kidney injuries and the underlying regulatory mechanisms. METHODS Neonatal rats were exposed to hyperoxia (80% O 2 ), treated with hUC-MSCs intratracheal (iT) or intraperitoneal (iP) on postnatal day 7, and harvested on postnatal day 21. The tissue sections of the lung, heart, and kidney were analyzed morphometrically. Protein contents of the bronchoalveolar lavage fluid (BALF), myeloperoxidase (MPO) expression, and malondialdehyde (MDA) levels were examined. Pulmonary inflammatory cytokines were measured via enzyme-linked immunosorbent assay. A comparative transcriptomic analysis of differentially expressed genes (DEGs) in lung tissue was conducted via RNA-sequencing. Subsequently, we performed reverse transcription-quantitative polymerase chain reaction and western blot analysis to explore the expression of target mRNA and proteins related to inflammatory and oxidative responses. RESULTS iT hUC-MSCs administration improved pulmonary alveolarization and angiogenesis ( P < 0.01, P < 0.01, P < 0.001, and P < 0.05 for mean linear intercept, septal counts, vascular medial thickness index, and microvessel density respectively). Meanwhile, treatment with hUC-MSCs iT ame liorated right ventricular hypertrophy (for Fulton’s index, P < 0.01), and relieved reduced nephrogenic zone width ( P < 0.01) and glomerular diameter ( P < 0.001) in kidneys. Among the beneficial effects, a reduction of BALF protein, MPO, and MDA was observed in hUC-MSCs groups ( P < 0.01, P < 0.001, and P < 0.05 respectively). Increased pro-inflammatory cytokines tumor necrosis factor-alpha, interleukin (IL)-1β, and IL-6 expression observed in the hyperoxia group were significantly attenuated by hUC-MSCs administration ( P < 0.01, P < 0.001, and P < 0.05 re...

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“…Recent studies have shown a correlation between the severity of BPD and NDI, with severe BPD being associated with a higher incidence of NDI [21,22]. In this study, we have not assessed the association between severity of BPD and NDI, which was not possible due to a low number of infants with severe BPD in our cohort.…”

Section: Discussionmentioning

confidence: 93%

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

Thomas

Jain

Murthy

et al. 2022

Paediatrics &Amp; Child Health

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Background More than 1 in 4 preterm infants with bronchopulmonary dysplasia (BPD) develop BPD-associated pulmonary hypertension (BPD-PH) that is associated with significant morbidity. Data regarding neurodevelopmental outcomes with BPD-PH in preterm infants are lacking. Objectives To determine neurodevelopmental outcomes of preterm infants born < 29 weeks gestational age (GA) with BPD associated pulmonary hypertension at 18 to 24 months corrected gestational age (CGA). Design/Methods In this retrospective cohort study, preterm infants born < 29 weeks GA between January 2016 and December 2019 at level 3 Neonatal Intensive Care Units at Foothills Hospital in Calgary and the University of Texas Medical Branch (UTMB) in Galveston, who were evaluated at 18-24 months CGA in the neonatal follow-up clinics were included. We compared demographic factors, neurodevelopmental status including Bayley-III scores and sensory impairments between the two groups based on the presence of PH at 36 weeks CGA: Group I: BPD with PH and Group II: BPD without PH, using univariate and multivariable regression models. The primary outcome was a composite of death or neurodevelopmental impairments (NDI). NDI was defined as any cerebral palsy (GMFCS≥1), Bayley-III score < 85 on one or more of the cognitive, motor, or language composite scores, sensorineural or mixed hearing impairment or unilateral or bilateral visual impairment. Results Of 372 eligible infants, 118 (Group I [BPD-PH] =7, Group II [BPD with no PH] =111) were lost to follow up. Of the remaining 254 infants, 52 in Group I and 202 in Group II were followed at 18-24 months CGA. Group I and Group II had median (IQR) birth weight of 710g (323) and 815g (314) [p=0.004] and median gestational ages (IQR) were 25 weeks (2) and 26 weeks (2) [p=0.020], respectively . Rates of associated impairments are shown in Figure 1. Infants in BPD-PH group (Group I) were more likely to have mortality or NDI (adjusted Odds Ratio [aOR] 3.82; 95% CI: 1.17-12.41) (Table 1). Conclusion BPD-PH in preterm infants born < 29 weeks GA is associated with increased odds of the composite outcome of death or neurodevelopmental impairment and language delay at 18-24 months CGA.

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

Cited by 44 publications

References 45 publications

Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks

Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks

Intratracheal administration of umbilical cord-derived mesenchymal stem cells attenuates hyperoxia-induced multi-organ injury via heme oxygenase-1 and JAK/STAT pathways

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

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

Cited by 44 publications

References 45 publications

Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks

Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks

Intratracheal administration of umbilical cord-derived mesenchymal stem cells attenuates hyperoxia-induced multi-organ injury via heme oxygenase-1 and JAK/STAT pathways

27 Neurodevelopmental Outcomes of Preterm Infants Born &lt;29 weeks with Bronchopulmonary Dysplasia Associated Pulmonary Hypertension: A Multicenter Study

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