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The impact of early tracheostomy on neurodevelopmental outcomes of infants with severe bronchopulmonary dysplasia exposed to postnatal corticosteroids

Journal of Perinatology (2023)Cite this article

Subjects

Abstract

Objective

To compare the cognitive, language and motor scores of infants with severe BPD exposed to postnatal corticosteroids (PCS) and had early (ET), late (LT) or no tracheostomy (NT).

Methods

Retrospective study was designed to compare the developmental outcomes of 71 infants born between 2010 and 2017 with severe BPD exposed to PCS and had ET (≤122 days), LT (>122 days), or NT.

Results

Cognitive scores were lower in LT versus NT and ET (p = 0.050); motor scores were worse in LT versus NT and ET (p = 0.004). Dexamethasone use was higher in LT versus NT and ET (p = 0.040). Adjusted for PCS, odds for major cognitive impairment were 90% less in ET versus LT. Trend for improved language and motor outcomes was seen in ET versus LT.

Conclusion

Infants with severe BPD exposed to PCS and had ET had significantly better cognitive, and trend toward improved language and motor outcomes.

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Fig. 1: Consortium diagram for the cohort.
Fig. 2: Relationship between composite scores and age at tracheostomy in weeks PMA with corresponding cumulative steroid exposure (hydrocortisone equivalent).

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the Medical Writing Center at Children’s Mercy Kansas City for their help in editing the manuscript.

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Authors and Affiliations

  1. Division of Neonatology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Amjad Taha, Gangaram Akangire, Tiffany Gladdis & Winston Manimtim

  2. Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    Amjad Taha, Gangaram Akangire, Janelle Noel-Macdonnell & Winston Manimtim

  3. Department of Health Services and Outcomes Research, Children’s Mercy Kansas City, Kansas City, MO, USA

    Janelle Noel-Macdonnell

  4. Department of Developmental and Behavioral Health, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    Tiffany Gladdis

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Contributions

AT, GA and WM conceptualized and designed the study. AT collected the data. AT, GA, TG, JN and WM analyzed the data. AT wrote the first draft. GA, JN, TG and WM revised the manuscript. All authors approved the final manuscript prior to submission.

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Correspondence to Gangaram Akangire.

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Taha, A., Akangire, G., Noel-Macdonnell, J. et al. The impact of early tracheostomy on neurodevelopmental outcomes of infants with severe bronchopulmonary dysplasia exposed to postnatal corticosteroids. J Perinatol (2023). https://doi.org/10.1038/s41372-023-01864-5

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