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Impact of bronchopulmonary dysplasia, brain injury, necrotizing enterocolitis, retinopathy of prematurity and sepsis on neurodevelopmental outcomes in premature infants

Journal of Perinatology (2025)Cite this article

Subjects

Abstract

Background

BPD, ROP, brain injury (severe IVH or PVL), NEC, and sepsis are independently associated with neurodevelopmental impairment (NDI).

Objectives

Evaluate the contribution of BPD, ROP, brain injury, NEC, and sepsis, individually or in combination with BPD, on NDI at 18-24 months corrected age (CA).

Methods

Demographic, NICU, and follow-up data from infants born ≤32 weeks gestational age with a birth weight <1500 grams were collected. NDI at 18–24 months CA was defined as blindness, deafness, or a composite score of <85 on the BSID-III. Univariate testing and logistic regression models were used.

Results

Univariate analysis revealed a significant association between moderate and severe BPD, brain injury, NEC, and ROP with NDI. Logistic regression showed infants with brain injury or NEC had significantly greater odds of developing NDI.

Conclusions

BPD with brain injury or NEC increases the risk of NDI. Infants with ≥3 comorbidities had significantly higher odds of NDI.

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Fig. 1: Study flow chart.

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Data availability

The data analyzed in this study is not publicly available. Datasets are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank Dr. Elizabeth R. Saslow, PhD, the developmental psychologist who conducted BSID-III assessments.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Cooper Medical School of Rowan University, Camden, NJ, USA

    Jack Donlon, Kristine Hawkins, Vishwanath Bhat, Krystal Hunter, Alla Kushnir & Vineet Bhandari

  2. Division of Neonatology, Department of Pediatrics, The Children’s Regional Hospital at Cooper, Camden, NJ, USA

    Vishwanath Bhat, Alla Kushnir & Vineet Bhandari

  3. Cooper Research Institute, Cooper University Hospital, Camden, NJ, USA

    Krystal Hunter

Authors
  1. Jack Donlon
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  2. Kristine Hawkins
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  3. Vishwanath Bhat
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  5. Alla Kushnir
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  6. Vineet Bhandari
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Contributions

Concept and design: Bhat and Bhandari; Acquisition, analysis, and interpretation of data: Donlon, Hawkins, Bhat, Hunter, Kushnir, Bhandari; Statistical analysis: Hunter; Initial draft of the manuscript: Donlon; Revision of manuscript: Donlon, Hawkins, Bhat, Hunter, Kushnir, Bhandari.

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Correspondence to Vineet Bhandari.

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Donlon, J., Hawkins, K., Bhat, V. et al. Impact of bronchopulmonary dysplasia, brain injury, necrotizing enterocolitis, retinopathy of prematurity and sepsis on neurodevelopmental outcomes in premature infants. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02549-x

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