Title:
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Respiratory outcome, executive function and health related quality of life of adult survivors of bronchopulmonary dysplasia
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Bronchopulmonary dysplasia (BPD) is the most common form of chronic lung
disease in infancy and a major complication in mechanically ventilated premature
babies. It has a mortality of up to 40% and develops in 20% of premature infants
born weighing under 1500g. With increased survival of extremely premature
infants, the incidence of BPD will remain high. Although those who survive are
considered 'miracles' of medical technology, current evidence suggests they suffer
significant health problems throughout childhood and adolescence. However,
almost nothing is known about those reaching adulthood.
This was a cross-sectional study of adult survivors of BPD (n=72) cared for in the
Neonatal Intensive Care Unit, Royal Maternity Hospital, Belfast (January 1979 to
April 1993). Two reference groups cared for in the same hospital were also
included; adults born preterm who did not develop BPD (n=58) and adults born at
term with normal birth weights (n=78).
Results show that BPD adults were significantly more likely to report respiratory
symptoms (wheeze and shortness of breath), use asthma medication and have
pulmonary impairment, particularly, reduced FEV1 and mid-expiratory flow rates
(FEF2S•7S ) compared with both the non-BPD and term controls. Significantly more
BPD adults had deficits in executive functioning related to problem solving and
organisation of their environment. Adult survivors of BPD utilise more health and
~ ....
social care services, report significantly reduced HRQol and greater social
dysfunction compared with controls.
The studies described in this thesis suggest significant health impairment associated
with BPD exists beyond the neonatal period and into adulthood and is not confined
to the respiratory system. The longitudinal follow up of larger cohorts of these
infants throughout adulthood is required in order to improve understanding and
raise awareness of long term health sequelae and identify more effective treatment
strategies.
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