{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T04:55:06Z","timestamp":1780116906168,"version":"3.54.0"},"reference-count":46,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,1,1]]},"abstract":"<jats:p>OBJECTIVE. The goal was to evaluate whether changes in neonatal intensive care have improved outcomes for children with bronchopulmonary dysplasia (oxygen dependence at corrected age of 36 weeks).<\/jats:p><jats:p>METHODS. We compared outcomes of extremely low birth weight (&amp;lt;1 kg) and extremely low gestational age (&amp;lt;28 weeks) infants with bronchopulmonary dysplasia between 2 periods (period I, 1996\u20131999: extremely low birth weight, n = 122; extremely low gestational age, n = 118; period II, 2000\u20132003: extremely low birth weight, n = 109; extremely low gestational age, n = 107).<\/jats:p><jats:p>RESULTS. For both groups, significant practice changes between period I and period II included increased prenatal and decreased postnatal steroid therapy and increased surfactant therapy, indomethacin therapy, and patent ductus arteriosus ligation. Significant morbidity changes included decreased rates of severe cranial ultrasound abnormalities and increased rates of ventilator dependence. Rates of bronchopulmonary dysplasia did not change (52% vs 53%). Follow-up evaluation revealed significantly lower rates of neurosensory abnormalities during period II (extremely low birth weight: 29% vs 16%; extremely low gestational age: 31% vs 16%). There were no changes in rates of Mental Developmental Index scores of &amp;lt;70 (extremely low birth weight: 42% vs 42%; extremely low gestational age: 37% vs 45%) or overall developmental impairment (extremely low birth weight: 51% vs 49%; extremely low gestational age: 50% vs 51%). For the extremely low gestational age group, predictors of neurosensory abnormalities were severe cranial ultrasound abnormality and postnatal steroid therapy. Predictors of overall impairment included severe cranial ultrasound abnormalities, ventilator dependence, postnatal steroid therapy, and patent ductus arteriosus ligation. For the extremely low birth weight group, the only predictor of neurosensory abnormalities was severe cranial ultrasound abnormality. Predictors of overall impairment included multiple birth, ventilator dependence, and severe cranial ultrasound abnormalities.<\/jats:p><jats:p>CONCLUSIONS. Neurosensory outcomes of infants with bronchopulmonary dysplasia improved during 2000 to 2003 but overall neurodevelopmental outcomes did not change.<\/jats:p>","DOI":"10.1542\/peds.2007-1444","type":"journal-article","created":{"date-parts":[[2007,12,31]],"date-time":"2007-12-31T17:23:13Z","timestamp":1199121793000},"page":"73-81","source":"Crossref","is-referenced-by-count":74,"title":["Outcomes of Extremely Low Birth Weight (&amp;lt;1 kg) and Extremely Low Gestational Age (&amp;lt;28 Weeks) Infants With Bronchopulmonary Dysplasia: Effects of Practice Changes in 2000 to 2003"],"prefix":"10.1542","volume":"121","author":[{"given":"Kristen","family":"Kobaly","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Schluchter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nori","family":"Minich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hudson Gerry","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanne","family":"Wilson-Costello","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Hack","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,1,1]]},"reference":[{"key":"2021120902181746400_R1","doi-asserted-by":"crossref","unstructured":"Fanaroff AA, Hack M, Walsh MC. The NICHD Neonatal Research Network: changes in practice and outcomes during the first 15 years. Semin Perinatol.\u20082003;27:281\u2013287","DOI":"10.1016\/S0146-0005(03)00055-7"},{"key":"2021120902181746400_R2","doi-asserted-by":"crossref","unstructured":"Schmidt B, Asztalos EV, Roberts RS, et al. Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms. JAMA.\u20082003;289:1124\u20131129","DOI":"10.1001\/jama.289.9.1124"},{"key":"2021120902181746400_R3","doi-asserted-by":"crossref","unstructured":"Majnemer A, Riley P, Shevell M, Birnbaum R, Greenstone H, Coates AL. Severe bronchopulmonary dysplasia increases risk for later neurological and motor sequelae in preterm survivors. Dev Med Child Neurol.\u20082000;42:53\u201360","DOI":"10.1111\/j.1469-8749.2000.tb00025.x"},{"key":"2021120902181746400_R4","unstructured":"Palta M, Sadek-Badawi M, Evans M, Weinstein MR, McGuinnes G. Functional assessment of a multicenter very low-birth-weight cohort at age 5 years: Newborn Lung Project. Arch Pediatr Adolesc Med.\u20082000;154:23\u201330"},{"key":"2021120902181746400_R5","doi-asserted-by":"crossref","unstructured":"Hughes CA, O'Gorman LA, Shyr Y, Schork MA, Bozynski ME, McCormick MC. Cognitive performance at school age of very low birth weight infants with bronchopulmonary dysplasia. J Dev Behav Pediatr.\u20081999;20:1\u20138","DOI":"10.1097\/00004703-199902000-00001"},{"key":"2021120902181746400_R6","doi-asserted-by":"crossref","unstructured":"Skidmore MD, Rivers A, Hack M. Increased risk of cerebral palsy among very low-birthweight infants with chronic lung disease. Dev Med Child Neurol.\u20081990;32:325\u2013332","DOI":"10.1111\/j.1469-8749.1990.tb16944.x"},{"key":"2021120902181746400_R7","doi-asserted-by":"crossref","unstructured":"Hack M, Wilson-Costello D, Friedman H, Taylor GH, Schluchter M, Fanaroff AA. Neurodevelopment and predictors of outcomes of children with birth weights of less than 1000 g: 1992\u20131995. Arch Pediatr Adolesc Med.\u20082000;154:725\u2013731","DOI":"10.1001\/archpedi.154.7.725"},{"key":"2021120902181746400_R8","doi-asserted-by":"crossref","unstructured":"Singer L, Yamashita T, Lilien L, Collin M, Baley J. A longitudinal study of developmental outcome of infants with bronchopulmonary dysplasia and very low birth weight. Pediatrics.\u20081997;100:987\u2013993","DOI":"10.1542\/peds.100.6.987"},{"key":"2021120902181746400_R9","doi-asserted-by":"crossref","unstructured":"O'Shea TM, Goldstein DJ, deRegnier RA, Sheaffer CI, Roberts DD, Dillard RG. Outcome at 4 to 5 years of age in children recovered from neonatal chronic lung disease. Dev Med Child Neurol.\u20081996;38:830\u2013839","DOI":"10.1111\/j.1469-8749.1996.tb15118.x"},{"key":"2021120902181746400_R10","doi-asserted-by":"crossref","unstructured":"Anderson PJ, Doyle LW. Neurodevelopmental outcome of bronchopulmonary dysplasia. Semin Perinatol.\u20082006;30:227\u2013232","DOI":"10.1053\/j.semperi.2006.05.010"},{"key":"2021120902181746400_R11","doi-asserted-by":"crossref","unstructured":"Doyle LW, Victorian Infant Collaborative Study Group. Respiratory function at age 8\u20139 years in extremely low birthweight\/very preterm children born in Victoria in 1991\u20131992. Pediatr Pulmonol.\u20082006;41:570\u2013576","DOI":"10.1002\/ppul.20412"},{"key":"2021120902181746400_R12","doi-asserted-by":"crossref","unstructured":"Kilbride HW, Gelatt MC, Sabath RJ. Pulmonary function and exercise capacity for ELBW survivors in preadolescence: effect of neonatal chronic lung disease. J Pediatr.\u20082003;143:488\u2013493","DOI":"10.1067\/S0022-3476(03)00413-X"},{"key":"2021120902181746400_R13","doi-asserted-by":"crossref","unstructured":"Korhonen P, Koivisto AM, Ikonen S, Laippala P, Tammela O. Very low birthweight, bronchopulmonary dysplasia and health in early childhood. Acta Paediatr.\u20081999;88:1385\u20131391","DOI":"10.1111\/j.1651-2227.1999.tb01056.x"},{"key":"2021120902181746400_R14","unstructured":"National Institutes of Health. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consens Statement.\u20081994;12:1\u201324"},{"key":"2021120902181746400_R15","doi-asserted-by":"crossref","unstructured":"Kilbride HW, Powers R, Wirtschafter DD, et al. Evaluation and development of potentially better practices to prevent neonatal nosocomial bacteremia. Pediatrics.\u20082003;111(4). 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Randomized placebo-controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight infants: outcome of study participants at 1-year adjusted age. Pediatrics.\u20081999;104:15\u201321","DOI":"10.1542\/peds.104.1.15"},{"key":"2021120902181746400_R19","doi-asserted-by":"crossref","unstructured":"Yeh TF, Lin YJ, Huang CC, et al. Early dexamethasone therapy in preterm infants: a follow-up study. Pediatrics.\u20081998;101(5). Available at: www.pediatrics.org\/cgi\/content\/full\/101\/5\/e7","DOI":"10.1542\/peds.101.5.e7"},{"key":"2021120902181746400_R20","doi-asserted-by":"crossref","unstructured":"Furman L, Hack M, Watts C, et al. Twenty-month outcome in ventilator-dependent, very low birth weight infants born during the early years of dexamethasone therapy. J Pediatr.\u20081995;126:434\u2013440","DOI":"10.1016\/S0022-3476(95)70464-7"},{"key":"2021120902181746400_R21","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Fetus and Newborn. Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. Pediatrics.\u20082002;109:330\u2013338","DOI":"10.1542\/peds.109.2.330"},{"key":"2021120902181746400_R22","doi-asserted-by":"crossref","unstructured":"Wilson-Costello D, Friedman H, Minich N, et al. Improved neurodevelopmental outcomes for extremely low birth weight infants in 2000\u20132002. Pediatrics.\u20082007;119:37\u201345","DOI":"10.1542\/peds.2006-1416"},{"key":"2021120902181746400_R23","doi-asserted-by":"crossref","unstructured":"Shennan AT, Dunn MS, Ohlsson A, Lennox K, Hoskins EM. Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics.\u20081988;82:527\u2013532","DOI":"10.1542\/peds.82.4.527"},{"key":"2021120902181746400_R24","doi-asserted-by":"crossref","unstructured":"Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med.\u20082001;163:1723\u20131729","DOI":"10.1164\/ajrccm.163.7.2011060"},{"key":"2021120902181746400_R25","unstructured":"Bayley N. Bayley Scales of Infant Development. 2nd ed. San Antonio, TX: Psychological Corp; 1993"},{"key":"2021120902181746400_R26","doi-asserted-by":"crossref","unstructured":"Bax MC. Terminology and classification of cerebral palsy. Dev Med Child Neurol.\u20081964;11:295\u2013297","DOI":"10.1111\/j.1469-8749.1964.tb10791.x"},{"key":"2021120902181746400_R27","unstructured":"World Health Organization. International Classification of Impairments, Disabilties and Handicaps. Geneva, Switzerland: World Heath Organization; 1980"},{"key":"2021120902181746400_R28","doi-asserted-by":"crossref","unstructured":"Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg.\u20081978;187:1\u20137","DOI":"10.1097\/00000658-197801000-00001"},{"key":"2021120902181746400_R29","doi-asserted-by":"crossref","unstructured":"Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr.\u20081978;92:529\u2013534","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"2021120902181746400_R30","unstructured":"Agresti A. Categorical Data Analysis. New York, NY: John Wiley and Sons; 1990:100\u2013102"},{"key":"2021120902181746400_R31","doi-asserted-by":"crossref","unstructured":"Kramer MS, Platt RW, Wen SW, et al. A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics.\u20082001;108(2). 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