Background: Neurodevelopmental outcome at school age has not been compared previously in premature infants with and without chronic lung disease (CLD) who received surfactant. Objective: To determine if CLD is a risk factor for abnormal neurodevelopment. Methods: A multicenter randomized trial comparing prophylactic to rescue surfactant in infants <30 wks gestation by dates was performed in 1985-1987 (Kendig et al, NEJM, 1991). 148/154 (96%) of survivors from our center were tested at 5-7 years of age by a pediatric psychologist and a pediatric neurologist. The McCarthy Scales of Children's Abilities intelligence scale, the Child Behavior checklist, and a neurological examination were performed. Teacher reports defined academic achievement and educational requirements including consultative services. The Hollingshead scale was used as an estimate of socioeconomic status (SES). Statistical Analysis: Infants requiring supplemental oxygen at 36 wks postmenstrual age (CLD36w) were compared to controls using two separate analyses. A case-control analysis matching for grade of IVH, gestational age (GA), birthweight, and SES was performed using paired Student t, chi square, and McNemar's tests. A second analysis used linear and logistic regression on the entire cohort testing independent variables of gender, GA, grade of IVH, SES, and CLD36w. p<0.05 was considered statistically significant. Results: Infants with CLD36w were more likely than controls to have an abnormal neurologic exam (45% vs. 20%), to have a General Cognitive Index <70 (30% vs. 15%) and to require formal Special Education (35% vs. 25%); however, no differences were statistically significant. Conclusion: CLD or bronchopulmonary dysplasia, defined as a supplemental oxygen requirement at 36 weeks postmenstrual age, is associated with a somewhat, but not dramatically, poorer neurodevelopmental outcome. CLD36w as a risk factor is greatly overshadowed by the more important risk factors of lower GA, higher grade of IVH and SES.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ryan, R., Myers, G., Kendig, J. et al. School Age Neurodevelopmental Outcome in Surfactant-Treated Premature Infants With and Without Chronic Lung Disease † 1584. Pediatr Res 41 (Suppl 4), 266 (1997). https://doi.org/10.1203/00006450-199704001-01603
Issue Date:
DOI: https://doi.org/10.1203/00006450-199704001-01603