|Title||Behavior Profiles at 2 Years for Children Born Extremely Preterm with Bronchopulmonary Dysplasia.|
|Publication Type||Journal Article|
|Year of Publication||2020|
|Authors||Brumbaugh JE, Bell EF, Grey SF, DeMauro SB, Vohr BR, Harmon HM, Bann CM, Rysavy MA, J Logan W, Colaizy TT, Peralta-Carcelen MA, McGowan EC, Duncan AF, Stoll BJ, Das A, Hintz SR|
|Corporate Authors||Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network|
|Date Published||2020 04|
|Keywords||Bronchopulmonary Dysplasia, Child, Preschool, Cognition, Female, Humans, Infant Behavior, Infant, Extremely Premature, Infant, Newborn, Language Development, Male, Motor Skills, Problem Behavior, Prospective Studies, Severity of Illness Index|
OBJECTIVE: To characterize behavior of 2-year-old children based on the severity of bronchopulmonary dysplasia (BPD).
STUDY DESIGN: We studied children born at 22-26 weeks of gestation and assessed at 22-26 months of corrected age with the Child Behavior Checklist (CBCL). BPD was classified by the level of respiratory support at 36 weeks of postmenstrual age. CBCL syndrome scales were the primary outcomes. The relationship between BPD grade and behavior was evaluated, adjusting for perinatal confounders. Mediation analysis was performed to evaluate whether cognitive, language, or motor skills mediated the effect of BPD grade on behavior.
RESULTS: Of 2310 children, 1208 (52%) had no BPD, 806 (35%) had grade 1 BPD, 177 (8%) had grade 2 BPD, and 119 (5%) had grade 3 BPD. Withdrawn behavior (P < .001) and pervasive developmental problems (P < .001) increased with worsening BPD grade. Sleep problems (P = .008) and aggressive behavior (P = .023) decreased with worsening BPD grade. Children with grade 3 BPD scored 2 points worse for withdrawn behavior and pervasive developmental problems and 2 points better for externalizing problems, sleep problems, and aggressive behavior than children without BPD. Cognitive, language, and motor skills mediated the effect of BPD grade on the attention problems, emotionally reactive, somatic complaints, and withdrawn CBCL syndrome scales (P values < .05).
CONCLUSIONS: BPD grade was associated with increased risk of withdrawn behavior and pervasive developmental problems but with decreased risk of sleep problems and aggressive behavior. The relationship between BPD and behavior is complex. Cognitive, language, and motor skills mediate the effects of BPD grade on some problem behaviors.
|Alternate Journal||J Pediatr|
|PubMed Central ID||PMC7096270|
|Grant List||L40 HD099827 / HD / NICHD NIH HHS / United States |
F32 HD098782 / HD / NICHD NIH HHS / United States
UG1 HD068244 / HD / NICHD NIH HHS / United States
UG1 HD034216 / HD / NICHD NIH HHS / United States
UG1 HD027904 / HD / NICHD NIH HHS / United States
KL2 TR003168 / TR / NCATS NIH HHS / United States
UG1 HD027880 / HD / NICHD NIH HHS / United States
UG1 HD053109 / HD / NICHD NIH HHS / United States
UG1 HD087229 / HD / NICHD NIH HHS / United States
UL1 TR003167 / TR / NCATS NIH HHS / United States
UG1 HD068278 / HD / NICHD NIH HHS / United States
U24 HD095254 / HD / NICHD NIH HHS / United States