Bronchopulmonary dysplasia: a longitudinal study of 20 cases
Zaramella, P.; Benini, F.; Dalla Barba, B.; Rossetti, A.; Zorzi, C.
Helvetica Paediatrica Acta 42(4): 263-271
1987
ISSN/ISBN: 0018-022X PMID: 3443552 Document Number: 303256
Of 20 patients with bronchopulmonary dysplasia (BPD), 17 survived (85%) and were followed prospectively up to one year post-term. Lower respiratory tract infections occurred in 12 patients (70.5%), and in 7 (41%) at least one hospital admission was required. At one year post-term follow-up, 9 patient (52.9%) continued to present respiratory symptoms, and 5 out of 13 (38.4%) radiographic changes. Six cases (35%) presented chronic cor pulmonale. Only 6 children (35%) showed normal growth, while the others showed deficits in one or more growth parameters. Cerebral palsy occurred in 41% of the children; 3 cases of severe tetraparesis and 4 of moderately severe palsy (hemiparesis or diplegia). Developmental quotient (DQ) was < 70 in 6 cases (35%), from 70-90 in 4 (23.5%), and > 90 in 7 (41%). The severe neurodevelopmental outcomes wre significantly correlated with the presence of important neonatal cerbral pathology (3-4.degree. IVH or periventricular leukomalacia). Retinopathy due to prematurity was diagnosed in 7 patients (41%), and in 5 it progressed to retrolental fibroplasia. Ten cases (58.8%) showed strabism, of which 8 had previous eye background involvement. Hearing deficit was not detected in any patient. Esthetic and functional sequelae consisted of scalp eschar (3 cases), post-thoracotomy scar (1 case), pleural drainage scars (3 cases), nasal deformity due to prolonged intubation (1 case), laryngeal stenosis (1 case), and post-tracheostomy stenosis (1 case). The findings of this study suggest that cardiorespiratory problems tend to improve, and in some cases resolve during the first year of life. Nonetheless, a high rate of neurodevelopmental and sensorial sequelae persists, which in our opinion is more related to perinatal events, such as hemorrhage and/or ischemic cerebral lesions, and exposure to hypoxia than to bronchopulmonary dysplasia.