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There is lack of evidence synthesis on the global consequences of bronchopulmonary dysplasia (BPD) in adolescence. Assess the impact of bronchopulmonary dysplasia on respiratory and non-respiratory outcomes in adolescents. A systematic review of studies assessing the outcomes of adolescents aged 10 to 19 years-old with BPD was conducted. We independently screened studies published until 6th March 2023 in PubMed® and Scopus® databases. Data on methodologic design, sample descriptive and findings were extracted from each study. Risk of bias was assessed using quality assessment tools. Thirty-one studies were included. Adolescents with a history of BPD present with more respiratory symptoms (wheezing, respiratory exacerbations, need for respiratory medication) and twenty-five studies showed a reduction in pulmonary function, with varying impact according to BPD severity and no differences before and after the surfactant era. Spirometry evaluation throughout the years is not consensual, but methacholine and salbutamol response in BPD groups is increased compared to non-BPD groups. Markers of eosinophilic airway inflammation are not increased as in asthma patients. Exercise potential is identical, but data regarding physical capacity and activity are inconsistent. More frequent radiologic abnormalities translate into higher high-resolution computed tomography scores, with linear (72.2 %) and triangular subpleural opacities (58.3 %) as the most common findings. There is a higher risk for special needs in education, but quality of life seems to be equal to non-BPD adolescents. BPD negatively impacts both pulmonary and non-pulmonary outcomes in adolescents. • Bronchopulmonary dysplasia(BPD) remains a common pathology in extreme premature birth. • The effects on adolescence are not well established. • BPD impacts adolescents' health both in respiratory and non-respiratory outcomes. • BPD adolescents show worse pulmonary function. • Exercise capacity and quality of life appear to be similar. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Due to a rising number of head deformities in healthy newborns, there has been an increasing interest in nonsynostotic head deformities in children over recent years. Although preterm infants are more likely to have anomalous head shapes than term newborns, there is limited data available on early prevalence of head deformities in preterm infants. Aims: The purposes of the present study were to acquire quantitative data on head shape of preterm infants at Term Equivalent Age (TEA), to determine the prevalence of symmetrical and asymmetrical head deformities and to identify possible risk factors. Methods: In a cross-sectional study design, Cranial Vault Asymmetry Index (CVAI) and Cranial Index (CI) calculated from routine head-scans with a non-invasive laser shape digitizer were recorded and categorized in type and severity of deformation for three different groups of gestational age. Perinatal and postnatal patient data was tested for possible associations. Results: Scans of 195 infants were included in the study. CVAI at TEA was higher in very preterm (4.1%) compared to term and late preterm infants. Prevalence of deformational plagiocephaly was 38% in very preterm infants. CI was lower in very (71.4%) and late (77.2%) preterm infants compared to term infants (80.0%). Compared to term babies (11%), a large number of very (73%) and late (28%) preterm infants exhibited dolichocephaly at TEA. Discussion: Prevalence of symmetrical and asymmetrical head deformities in preterm infants is high at TEA. Interventions are required to prevent head deformities in preterm infants during the initial hospital stay. [Copyright &y& Elsevier]

Objective: To investigate the influence of perinatal risk factors, especially hypotension, on neuromotor status at term in surviving preterm infants born before 32 weeks of gestation. Methods: This study is part of the Leiden Follow-Up Project on Prematurity: a prospective, regional study of 266 live born infants with a gestational age (GA) <32 weeks born in 1996–1997. Twenty-eight infants died before term age. Two hundred and eleven infants were examined neurologically at term according to Prechtl. The findings were classified as normal (N), mildly abnormal (MA) or definitely abnormal (DA). Hypotension was defined as a mean arterial blood pressure (MABP) <30 mm Hg on at least two occasions. Results: One hundred and six (50%) infants were classified as neurologically N, 92 (44%) infants were classified as MA and 13 (6%) infants as DA. Hypotension, bronchopulmonary dysplasia (BPD), flaring and cystic periventricular leucomalacia (PVL) were risk factors for neurological morbidity. Of the 68 infants with hypotension, 33 (49%) were classified as MA and 7 (10%) as DA. Of the 141 infants without hypotension, 58 (41%) were MA, and 5 (4%) were DA. The odds ratio of hypotension for neurological morbidity was 1.9 (95% CI 1.06–3.40), adjusted for gestational age, birth weight, small for gestational age (SGA) and gender, it was 1.96 (95% CI 1.02–3.77). The adjusted odds ratio of PVL was 18.6 (4.4–78.5), of flaring was 2.37 (1.18–4.74) and of BPD was 2.44 (1.08–5.5). Conclusions: Apart from gestational age, periventricular leucomalacia, and bronchopulmonary dysplasia, hypotension in preterm infants is a major risk factor for neurological morbidity at term. [Copyright &y& Elsevier]

Objective: To determine the effect of prematurity (gestational age (GA) <32 weeks) on developmental outcome at the corrected age of 18 and 24 months in a regionally defined, prospective cohort study. Study design: The Leiden Follow-Up Project on Prematurity (LFUPP) includes all live-born infants <32 weeks GA, born in 1996/1997 in three Dutch health regions (n=266). Mental and psychomotor developmental indices (MDI, PDI) were determined with the Bayley Scales of Infant Development I: ≥−1 S.D.: normal, −2 to −1 S.D.: moderate delay and <−2 S.D.: severe delay. Results: At 18 months 168 (71%) and at 24 months, 151 children (64%) of 235 survivors were assessed. Moderate to severely delayed mental and/or psychomotor development occurred in 40% of the children at both ages. Children lost to follow-up were of lower socioeconomic status and more frequently of non-Dutch origin. Since non-Dutch origin negatively affected the outcome at both test ages, availability of the data of these children would probably have worsened the outcome. Postnatal treatment with dexamethasone was associated with an increased risk of delayed development. Other independent predictors of delayed development were bronchopulmonary dysplasia at 18 months and ethnicity, maternal age at birth, birthweight and gender at 24 months. After adjustment for these other predictors of delayed development, the mean PDI of dexamethasone-treated infants was 16.1 points lower than of non-treated infants at 18 months (p=0.03) and 12.7 points lower at 24 months (p=0.04). Conclusions: At 18 and 24 months corrected age, 40% of the very prematurely born children had both delayed mental and/or psychomotor development. Treatment with dexamethasone postnatally was a major risk factor for delayed (psychomotor) development. [Copyright &y& Elsevier]

Plasma antioxidant capacity in very preterm infants (n=17), measured as the ferric-reducing ability of plasma (FRAP), increased significantly until day 2 postpartum and decreased thereafter until day 7. Within this period, the FRAP values in matched infants, born after impaired placental function (IPF, n=17), did not change. Their FRAP values were lower and the incidence of oxidative stress-related diseases was significantly higher in these infants. [Copyright &y& Elsevier]

Background and Objective: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the 1-year development of infants born with a gestational age of less than 32 weeks. Methods: All surviving infants (11 in the NIDCAP group and 9 in the control group) were assessed employing the Bayley Scales of Infant Development at 1 year of corrected age. Results: The Mental Developmental Index (MDI) of children who had received care according to NIDCAP was higher [88 (72–114)] [median (range)] than the corresponding value for the control children [78 (50–82)] (p=0.01). The odds ratio for being alive with an MDI>80 was 14 (95% CI; 1.4–141.5) in favour of the intervention group. However, the Psychomotor Developmental Indices (PDI) were not significantly different [85 (61–108) and 69 (50–114), respectively] (p=0.23). Conclusion: Our findings indicate that care based on the NIDCAP might have a positive impact on the cognitive development of infants born very prematurely. [Copyright &y& Elsevier]

Background: Prostacyclin (PGI2) and thromboxane A2 (TxA2) may take part in lung pathology; high concentrations of PGI2 may protect newborn rabbits against hyperoxic lung injury, and TxA2 may participate in the development of bronchopulmonary dysplasia (BPD). Aims: To examine in small preterm infants, the relationship between pulmonary PGI2 and TxA2 and respiratory distress during the early postnatal period. Methods: The stable metabolite of prostacyclin, 6-keto-prostaglandinF1alpha, and that of thromboxane A2, thromboxane B2, were quantified by radioimmunoassays in 284 samples of tracheal aspirates from 48 infants (GA: 27.4±2.1 week, BW 959±334 g) during the first 12 postnatal days. Results: Mean concentration of 6-keto-prostaglandinF1alpha was 414±31 pg/ml (mean±S.E.M.), and of thromboxane B2 was 418±37 pg/ml. Correlations existed between 6-keto-prostaglandinF1alpha and gestational age, birth weight, and the initial arterial–alveolar oxygenation ratio. Negative correlations existed between 6-keto-prostaglandinF1alpha and both mean inspiratory oxygen and duration of mechanical ventilation. Indomethacin treatment was associated with lower pulmonary 6-keto-prostaglandinF1alpha, but not with lower TxB2. Thromboxane B2 correlated positively with gestational age, birth weight, and initial arterial–alveolar oxygenation ratio, and inversely with duration of mechanical ventilation. Conclusions: In preterm infants, higher pulmonary 6-keto-prostaglandinF1alpha was associated with less severe respiratory distress and with maturity, whereas thromboxane B2 was associated more strongly with maturity than with respiratory distress. [Copyright &y& Elsevier]