264 - Risk factors for neurodevelopmental impairment at two and five years corrected age in preterm infants with established bronchopulmonary dysplasia

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 264
Publication Number: 264.34

Trix A. Katz, Emma Children's Hospital Amsterdam UMC, Amsterdam, Noord-Holland, Netherlands; Suzanne M. Mugie, Amsterdam UMC, Amsterdam, Noord-Holland, Netherlands; Wes Onland, Emma Children's Hospital Amsterdam UMC, Amsterdam, Noord-Holland, Netherlands; Anton van Kaam, Emma Children's Hospital Amsterdam UMC, Amsterdam, Noord-Holland, Netherlands; Cornelieke SH. Aarnoudse-Moens, Amsterdam UMC, Amsterdam, Noord-Holland, Netherlands; Aleid Leemhuis, Amsterdam UMC, Amsterdam, Noord-Holland, Netherlands

Presenting Author(s)

Trix A. Katz, MD (she/her/hers)

PhD student
Emma Children's Hospital Amsterdam UMC
Amsterdam, Noord-Holland, Netherlands

Background: Although the association between bronchopulmonary dysplasia (BPD) and adverse neurodevelopmental outcome till childhood is consistently reported in literature, the pathophysiological mechanism causing the association is complex and remains to be elucidated given that only approximately half of the infants with established BPD will develop neurodevelopmental impairment (NDI).

Objective:

To identify risk factors for NDI at two- and five years corrected age (CA) within a cohort of preterm infants with established BPD.

Design/Methods: This single center retrospective cohort study included infants born between 2009 and 2016 at a gestational age < 30 weeks with moderate or severe BPD according to the 2001 NIH definition. Potential risk factors for NDI, such as perinatal characteristics, (social) demographics, respiratory interventions and comorbidities were collected from the electronic patient records. Odds ratios for NDI at two- and five years CA were calculated with univariate analyses, and with multivariate logistic regression analyses adjusting for potential confounders, identified using direct acyclic graphs.

Results:

Of the 602 admitted and eligible infants, 123 infants were diagnosed with moderate or severe BPD at 36 weeks’ postmenstrual age. NDI was present in 30.3% at two years CA, and in 56.1% at five years CA. In the univariate analyses at two years CA, birthweight (BW) (OR 0.78, 95% CI 0.64-0.99), small for gestational age (OR 2.77, 95% CI 1.03-7.46), administration of dexamethasone (OR 4.99, 95% CI 1.70-14.7), and duration of mechanical ventilation (OR 1.06, 95% CI 1.01-1.11) were associated with NDI.
At five years CA, the univariate analyses showed a significant association for BW (OR 0.76, 95% CI 0.59-0.97), administration of dexamethasone (OR 4.46, 95% CI 1.36-14.7), days on oxygen (OR 1.03, 95% CI 1.01-1.04), sepsis (OR 2.37, 95% CI 1.04-5.38), and NICU stay (OR 1.02, 95% CI 1.00-1.03). However, after correcting for potential confounders the only variable independently associated with NDI at both two and five years CA was the BW (aOR 0.74, 95% CI 0.57-0.95; aOR 0.70, 95% CI 0.54-0.91, respectively), and male gender for NDI at five years CA (OR 2.49, 95% CI 1.11-5.57).

Conclusion(s): BW is the only independent risk factor for NDI at two and five years CA in preterm infants with BPD. In contrast, well known risk factors for NDI in the general population of preterm infants, such as GA, maternal education, and neonatal comorbidities were not independent risk factors for NDI.