Pulmonary sequelae in long-term survivors of bronchopulmonary dysplasia

Background: Bronchopulmonary dysplasia (BPD) is a common problem in prematu re babies. Long-term sequelae are the main concerns. Methods: A retrospective review of all BPD children born in Queen Mary Hosp ital, a teaching hospital of the University of Hong Kong, from January 1987 to December 1995 was conducted. Children with cerebral palsy, immunodefici ency, congenital heart disorders, renal or liver failure were excluded from analysis. Chest radiography (CXR), electrocardiogram (ECG) and pulse oxime try were routinely performed. Results: Fifty-five children completed the study. The female to male ratio was 1 : 1.1. The mean gestational age was 28 weeks. Twenty-five children we re born with a birthweight of less than 1001 g. Mean age at assessment was 5.4 years. Twenty-four children (44%) demonstrated signs or symptoms of cur rent asthma. Only seven children managed to perform the spirometry satisfac torily. One child had low forced vital capacity and one had hyperresponsive airway. The only risk factor found to be associated with current asthma wa s the birth month, with those children born early in the year at higher ris k of developing current asthma. Seventeen of 48 children (35%) had a bodywe ight below the third percentile at the corrected age of 1 year. Eleven of t hese seventeen children (65%) demonstrated catch-up growth at assessment. A bnormal CXR was found in 25 of 40 children (63%). All had normal pulse oxim etry and EGG. Conclusions: Bronchopulmonary dysplasia children had a significantly higher risk than the general population of developing current asthma (odds ratio 4.7; 95% confidence interval 3.4-6.5; P < 0.0001). The importance of birth month suggests that early life experience is important in the pathogenesis of asthma, even in BPD children. The long-term growth of BPD children was m uch better than previously reported.