{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T03:18:11Z","timestamp":1778210291424,"version":"3.51.4"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institutional Fund Projects","award":["IFPHI-100-248-2020"],"award-info":[{"award-number":["IFPHI-100-248-2020"]}]},{"name":"Institutional Fund Projects","award":["IFPHI-100-248-2020"],"award-info":[{"award-number":["IFPHI-100-248-2020"]}]},{"name":"Institutional Fund Projects","award":["IFPHI-100-248-2020"],"award-info":[{"award-number":["IFPHI-100-248-2020"]}]},{"name":"Institutional Fund Projects","award":["IFPHI-100-248-2020"],"award-info":[{"award-number":["IFPHI-100-248-2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The existing literature lacks conclusive evidence regarding the relationship between bronchopulmonary dysplasia (BPD) and cerebral palsy (CP). This large epidemiological study aimed to explore the co-occurrence of BPD and CP among children. Methods: This retrospective cohort analysis utilized the National Inpatient Sample (NIS) dataset from 2016 to 2019, investigating pediatric patients with BPD and CP diagnoses. Descriptive and inferential statistics, including univariate and multivariate regression analyses, were conducted to explore the association between BPD and CP. Results: Overall, 3,951,039 patients were analyzed. Among them, 28,880 patients had CP (n = 796 with BPD and n = 28,084 without BPD). The rates of intraventricular hemorrhage grade 3 and 4, central nervous system anomalies, chromosomal disorders, retinopathy of prematurity (\u2265grade 3), periventricular leukomalacia, prematurity, and low birth weight were significantly higher in the CP-with-BPD arm contrasted to the CP-without-BPD arm. Univariate regression demonstrated a significant BPD\u2013CP association (odds ratio [OR] = 7.78, 95% confidence interval [CI]: 7.24\u20138.37, p &lt; 0.0001). Multivariate analysis, adjusting for various confounders, reinforced this association (OR = 5.70, 95% CI: 5.17\u20136.28, p &lt; 0.0001). We observed a significant association between increasing prematurity in neonates with BPD and an elevated risk of CP. Conclusions: This nationwide study identified a strong correlation between the co-occurrence of BPD and CP, though it does not establish causality. Rigorous adjustments revealed that patients with BPD appear to have a six-fold increased likelihood of being diagnosed with CP later on, compared to those without BPD. While aligned with the existing literature, this study represents the largest sample size with recommendations for targeted preventive strategies to mitigate the burden of CP.<\/jats:p>","DOI":"10.3390\/children11091129","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T09:43:13Z","timestamp":1726652593000},"page":"1129","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation between Bronchopulmonary Dysplasia and Cerebral Palsy in Children: A Comprehensive Analysis Using the National Inpatient Sample Dataset"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2759-0218","authenticated-orcid":false,"given":"Abdulrahman","family":"Al-Matary","sequence":"first","affiliation":[{"name":"Department of Neonatology, King Fahad Medical City, Riyadh 11525, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameh","family":"Abozaid","sequence":"additional","affiliation":[{"name":"Department of Neonatology, King Fahad Medical City, Riyadh 11525, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Al Suliman","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Maternity and Children Hospital, Madinah 42313, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Alsubaie","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Maternity and Children Hospital, Madinah 42313, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal K","family":"Aldandan","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Maternity and Children Hospital, Madinah 42313, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal Mohammed","family":"Alzehairi","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Alyamamah Hospital, Riyadh 14222, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huda Yahya","family":"Alyahyawi","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abrar Nayel","family":"Alsharief","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghadeer Ghazi","family":"Alahmadi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3565-955X","authenticated-orcid":false,"given":"Faris","family":"Althubaiti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naseem","family":"Alyahyawi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3125-5260","authenticated-orcid":false,"given":"Ahlam","family":"Mazi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Abu-Zaid","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hind","family":"Alnajashi","sequence":"additional","affiliation":[{"name":"Department of Neurology, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-8435","authenticated-orcid":false,"given":"Reem Abdullah","family":"Alyoubi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Abdulaziz University, Jeddah 11461, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.2147\/NDT.S235165","article-title":"Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options","volume":"16","author":"Sadowska","year":"2020","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.siny.2011.04.004","article-title":"Myth: Cerebral palsy cannot be predicted by neonatal brain imaging","volume":"16","author":"Benders","year":"2011","journal-title":"Semin. Fetal Neonatal Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1177\/0883073815596610","article-title":"Age at Referral of Children for Initial Diagnosis of Cerebral Palsy and Rehabilitation: Current Practices","volume":"31","author":"Hubermann","year":"2016","journal-title":"J. Child. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hadders-Algra, M. (2014). Early diagnosis and early intervention in cerebral palsy. Front. Neurol., 5.","DOI":"10.3389\/fneur.2014.00185"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jpeds.2012.07.044","article-title":"Normal imaging in patients with cerebral palsy: What does it tell us?","volume":"162","author":"Benini","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.21037\/tp.2020.01.01","article-title":"Cerebral palsy in children: A clinical overview","volume":"9","author":"Patel","year":"2020","journal-title":"Transl. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Miller, F., Bachrach, S., Lennon, N., and O\u2019Neil, M. (2019). Bronchopulmonary Dysplasia and Cerebral Palsy. Cerebral Palsy, Springer International Publishing.","DOI":"10.1007\/978-3-319-50592-3"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e020735","DOI":"10.1136\/bmjopen-2017-020735","article-title":"Association between bronchopulmonary dysplasia and cerebral palsy in children: A meta-analysis","volume":"8","author":"Gou","year":"2018","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Li, W., Wang, Y., Song, J., Zhang, C., Xu, Y., Xu, F., Wang, X., and Zhu, C. (2023). Association between bronchopulmonary dysplasia and death or neurodevelopmental impairment at 3\u2009years in preterm infants without severe brain injury. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1292372"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1080\/14767058.2019.1646240","article-title":"Global incidence of bronchopulmonary dysplasia among extremely preterm infants: A systematic literature review","volume":"34","author":"Siffel","year":"2021","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bonadies, L., Zaramella, P., Porzionato, A., Perilongo, G., Muraca, M., and Baraldi, E. (2020). Present and Future of Bronchopulmonary Dysplasia. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051539"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1038\/s41372-019-0548-x","article-title":"Hospitalization costs associated with bronchopulmonary dysplasia in the first year of life","volume":"40","author":"Lapcharoensap","year":"2020","journal-title":"J. Perinatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1159\/000533653","article-title":"Risk Factors for Neurodevelopmental Impairment at 2- and 5-Years Corrected Age in Preterm Infants with Established Bronchopulmonary Dysplasia","volume":"121","author":"Katz","year":"2023","journal-title":"Neonatology"},{"key":"ref_14","unstructured":"HCUP National Inpatient Sample (NIS) (2023, November 04). Healthcare Cost and Utilization Project (HCUP), Available online: www.hcup-us.ahrq.gov\/nisoverview.jsp."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1080\/14767058.2018.1536745","article-title":"Risk of cerebral palsy by gestational age among pregnancies at-risk for preterm birth","volume":"33","author":"Smith","year":"2020","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"F20","DOI":"10.1136\/adc.2010.183012","article-title":"Does bronchopulmonary dysplasia contribute to the occurrence of cerebral palsy among infants born before 28 weeks of gestation?","volume":"96","author":"Kuban","year":"2011","journal-title":"Arch. Dis. Child Fetal Neonatal Ed."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.ajog.2004.05.032","article-title":"Outcome of extremely-low-birth-weight infants at highest risk: Gestational age < or =24 weeks, birth weight < or =750 g, and 1-minute Apgar < or =3","volume":"191","author":"Shankaran","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1165\/rcmb.2018-0192OC","article-title":"Caspase-1 Inhibition Attenuates Hyperoxia-induced Lung and Brain Injury in Neonatal Mice","volume":"61","author":"Zambrano","year":"2019","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Thomas, J.M., Sudhadevi, T., Basa, P., Ha, A.W., Natarajan, V., and Harijith, A. (2022). The Role of Sphingolipid Signaling in Oxidative Lung Injury and Pathogenesis of Bronchopulmonary Dysplasia. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23031254"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ali, A., Zambrano, R., Duncan, M.R., Chen, S., Luo, S., Yuan, H., Chen, P., Benny, M., Schmidt, A., and Young, K. (2021). Hyperoxia-activated circulating extracellular vesicles induce lung and brain injury in neonatal rats. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-87706-w"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3076","DOI":"10.1002\/jnr.22139","article-title":"Oxidative stress disrupts oligodendrocyte maturation","volume":"87","author":"French","year":"2009","journal-title":"J. Neurosci. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1038\/s41390-020-01162-2","article-title":"Bronchopulmonary dysplasia precursors influence risk of white matter injury and adverse neurodevelopmental outcome in preterm infants","volume":"90","author":"Grelli","year":"2021","journal-title":"Pediatr. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e2312277","DOI":"10.1001\/jamanetworkopen.2023.12277","article-title":"Assessment of Corticosteroid Therapy and Death or Disability According to Pretreatment Risk of Death or Bronchopulmonary Dysplasia in Extremely Preterm Infants","volume":"6","author":"Jensen","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Barrington, K.J. (2001). The adverse neuro-developmental effects of postnatal steroids in the preterm infant: A systematic review of RCTs. BMC Pediatr., 1.","DOI":"10.1186\/1471-2431-1-1"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1111\/apa.16696","article-title":"Postnatal corticosteroids and developmental outcomes in extremely preterm or extremely low birth weight infants: The Victorian Infant Collaborative Study 2016-17 cohort","volume":"112","author":"Douglas","year":"2023","journal-title":"Acta Paediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.ajog.2003.12.016","article-title":"Repeated antenatal corticosteroids: Effects on cerebral palsy and childhood behavior","volume":"190","author":"French","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Muehlbacher, T., Bassler, D., and Bryant, M.B. (2021). Evidence for the Management of Bronchopulmonary Dysplasia in Very Preterm Infants. Children, 8.","DOI":"10.3390\/children8040298"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1129\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:58:16Z","timestamp":1760111896000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["children11091129"],"URL":"https:\/\/doi.org\/10.3390\/children11091129","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,18]]}}}