Abstract
Objective: To characterize behavior of 2-year-old children based on the severity of bronchopulmonary dysplasia (BPD). Study design: We studied children born at 22-26 weeks of gestation and assessed at 22-26 months of corrected age with the Child Behavior Checklist (CBCL). BPD was classified by the level of respiratory support at 36 weeks of postmenstrual age. CBCL syndrome scales were the primary outcomes. The relationship between BPD grade and behavior was evaluated, adjusting for perinatal confounders. Mediation analysis was performed to evaluate whether cognitive, language, or motor skills mediated the effect of BPD grade on behavior. Results: Of 2310 children, 1208 (52%) had no BPD, 806 (35%) had grade 1 BPD, 177 (8%) had grade 2 BPD, and 119 (5%) had grade 3 BPD. Withdrawn behavior (P < .001) and pervasive developmental problems (P < .001) increased with worsening BPD grade. Sleep problems (P = .008) and aggressive behavior (P = .023) decreased with worsening BPD grade. Children with grade 3 BPD scored 2 points worse for withdrawn behavior and pervasive developmental problems and 2 points better for externalizing problems, sleep problems, and aggressive behavior than children without BPD. Cognitive, language, and motor skills mediated the effect of BPD grade on the attention problems, emotionally reactive, somatic complaints, and withdrawn CBCL syndrome scales (P values < .05). Conclusions: BPD grade was associated with increased risk of withdrawn behavior and pervasive developmental problems but with decreased risk of sleep problems and aggressive behavior. The relationship between BPD and behavior is complex. Cognitive, language, and motor skills mediate the effects of BPD grade on some problem behaviors.
| Original language | English |
|---|---|
| Pages (from-to) | 152-159.e5 |
| Journal | Journal of Pediatrics |
| Volume | 219 |
| DOIs | |
| State | Published - Apr 2020 |
| Externally published | Yes |
Keywords
- BPD
- bayley scales of infant and toddler development
- child behavior checklist
- cognitive
- infants born premature
- language
- motor
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In: Journal of Pediatrics, Vol. 219, 04.2020, p. 152-159.e5.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Behavior Profiles at 2 Years for Children Born Extremely Preterm with Bronchopulmonary Dysplasia
AU - Brumbaugh, Jane E.
AU - Bell, Edward F.
AU - Grey, Scott F.
AU - DeMauro, Sara B.
AU - Vohr, Betty R.
AU - Harmon, Heidi M.
AU - Bann, Carla M.
AU - Rysavy, Matthew A.
AU - Logan, J. Wells
AU - Colaizy, Tarah T.
AU - Peralta-Carcelen, Myriam A.
AU - McGowan, Elisabeth C.
AU - Duncan, Andrea F.
AU - Stoll, Barbara J.
AU - Das, Abhik
AU - Hintz, Susan R.
AU - Caplan, Michael S.
AU - Polin, Richard A.
AU - Laptook, Abbot R.
AU - Keszler, Martin
AU - Hensman, Angelita M.
AU - Vieira, Elisa
AU - Little, Emilee
AU - Burke, Robert T.
AU - Stephens, Bonnie E.
AU - Alksninis, Barbara
AU - Bishop, Carmena
AU - Keszler, Mary L.
AU - Leach, Teresa M.
AU - Watson, Victoria E.
AU - Knoll, Andrea M.
AU - Walsh, Michele C.
AU - Fanaroff, Avroy A.
AU - Newman, Nancy S.
AU - Wilson-Costello, Deanne E.
AU - Payne, Allison
AU - Bhola, Monika
AU - Yalcinkaya, Gulgun
AU - Siner, Bonnie S.
AU - Friedman, Harriet G.
AU - Roth, Elizabeth
AU - Truog, William E.
AU - Pallotto, Eugenia K.
AU - Kilbride, Howard W.
AU - Gauldin, Cheri
AU - Holmes, Anne
AU - Johnson, Kathy
AU - Knutson, Allison
AU - Schibler, Kurt
AU - Poindexter, Brenda B.
AU - Merhar, Stephanie
AU - Yolton, Kimberly
AU - Gratton, Teresa L.
AU - Grisby, Cathy
AU - Kirker, Kristin
AU - Wuertz, Sandra
AU - Carlton, David P.
AU - Adams-Chapman, Ira
AU - Hale, Ellen C.
AU - Loggins, Yvonne C.
AU - Bottcher, Diane I.
AU - Mackie, Colleen
AU - Carter, Sheena L.
AU - LaRossa, Maureen Mulligan
AU - Wineski, Lynn C.
AU - Smikle, Gloria V.
AU - Leon-Hernandez, Angela
AU - Kendrick-Allwood, Salathiel
AU - Cotten, C. Michael
AU - Goldberg, Ronald N.
AU - Goldstein, Ricki F.
AU - Malcolm, William F.
AU - Ashley, Patricia L.
AU - Finkle, Joanne
AU - Fisher, Kimberley A.
AU - Grimes, Sandra
AU - Gustafson, Kathryn E.
AU - Laughon, Matthew M.
AU - Bose, Carl L.
AU - Bernhardt, Janice
AU - Bose, Gennie
AU - Warner, Diane
AU - Wereszczak, Janice
AU - Kicklighter, Stephen D.
AU - Rhodes-Ryan, Ginger
AU - Higgins, Rosemary D.
AU - Wilson Archer, Stephanie
AU - Sokol, Gregory M.
AU - Papile, Lu Ann
AU - Hines, Abbey C.
AU - Herron, Dianne E.
AU - Gunn, Susan
AU - Smiley, Lucy
AU - Kennedy, Kathleen A.
AU - Tyson, Jon E.
AU - Arldt-McAlister, Julie
AU - Burson, Katrina
AU - Dempsey, Allison G.
AU - Evans, Patricia W.
AU - Garcia, Carmen
AU - Jiminez, Margarita
AU - John, Janice
AU - Jones, Patrick M.
AU - Lillie, M. Layne
AU - Martin, Karen
AU - Martin, Sara C.
AU - McDavid, Georgia E.
AU - Rodgers, Shawna
AU - Siddiki, Saba Khan
AU - Sperry, Daniel
AU - Pierce Tate, Patti L.
AU - Wright, Sharon L.
AU - Sánchez, Pablo J.
AU - Nelin, Leif D.
AU - Jadcherla, Sudarshan R.
AU - Luzader, Patricia
AU - Fortney, Christine A.
AU - Besner, Gail E.
AU - Parikh, Nehal A.
AU - Wallace, Dennis
AU - Gantz, Marie G.
AU - Newman, Jamie E.
AU - Auman, Jeanette O.Donnell
AU - Crawford, Margaret
AU - Gabrio, Jenna
AU - Leblond, David
AU - Petrie Huitema, Carolyn M.
AU - Zaterka-Baxter, Kristin M.
AU - Van Meurs, Krisa P.
AU - Chock, Valerie Y.
AU - Stevenson, David K.
AU - Adams, Marian M.
AU - Ball, M. Bethany
AU - Bentley, Barbara
AU - DeAnda, Maria Elena
AU - Debattista, Anne M.
AU - Earhart, Beth
AU - Huffman, Lynne C.
AU - Ismael, Magdy
AU - Krueger, Casey E.
AU - Palmquist, Andrew W.
AU - Proud, Melinda S.
AU - Reichert, Elizabeth N.
AU - Sankar, Meera N.
AU - St. John, Nicholas H.
AU - Taylor, Heather L.
AU - Weiss, Hali E.
AU - Frantz, Ivan D.
AU - Fiascone, John M.
AU - MacKinnon, Brenda L.
AU - Nylen, Ellen
AU - Furey, Anne
AU - Sibley, Cecelia E.
AU - Brussa, Ana K.
AU - Carlo, Waldemar A.
AU - Ambalavanan, Namasivayam
AU - Bailey, Kirstin J.
AU - Biasini, Fred J.
AU - Collins, Monica V.
AU - Cosby, Shirley S.
AU - Phillips, Vivien A.
AU - Rector, Richard V.
AU - Whitley, Sally
AU - Devaskar, Uday
AU - Garg, Meena
AU - Purdy, Isabell B.
AU - Chanlaw, Teresa
AU - Geller, Rachel
AU - Finer, Neil N.
AU - Vaucher, Yvonne E.
AU - Kaegi, David
AU - Rasmussen, Maynard R.
AU - Arnell, Kathy
AU - Demetrio, Clarence
AU - Fuller, Martha G.
AU - Rich, Wade
AU - West, Radmila
AU - Baack, Michelle L.
AU - Ellsbury, Dan L.
AU - Hogden, Laurie A.
AU - Klein, Jonathan M.
AU - Dagle, John M.
AU - Johnson, Karen J.
AU - Tud, Tracy L.
AU - Elenkiwich, Chelsey
AU - Henning, Megan M.
AU - Broadbent, Megan
AU - Schmelzel, Mendi L.
AU - Walker, Jacky R.
AU - Goeke, Claire A.
AU - Watterberg, Kristi L.
AU - Ohls, Robin K.
AU - Backstrom Lacy, Conra
AU - Brown, Sandra
AU - Fuller, Janell
AU - Hartenberger, Carol
AU - Lowe, Jean R.
AU - Sundquist Beauman, Sandra
AU - Hanson, Mary Ruffner
AU - Dupont, Tara
AU - Kuan, Elizabeth
AU - Schmidt, Barbara
AU - Kirpalani, Haresh
AU - Chaudhary, Aasma S.
AU - Abbasi, Soraya
AU - Mancini, Toni
AU - Cucinotta, Dara M.
AU - Bernbaum, Judy C.
AU - Gerdes, Marsha
AU - Hurt, Hallam
AU - D'Angio, Carl T.
AU - Guillet, Ronnie
AU - Myers, Gary J.
AU - Lakshminrusimha, Satyan
AU - Reynolds, Anne Marie
AU - Hartley-McAndrew, Michelle E.
AU - Wadkins, Holly I.M.
AU - Sacilowski, Michael G.
AU - Reubens, Linda J.
AU - Jensen, Rosemary L.
AU - Merzbach, Joan
AU - Zorn, William
AU - Farooq, Osman
AU - Maffett, Deanna
AU - Williams, Ashley
AU - Hunn, Julianne
AU - Guilford, Stephanie
AU - Yost, Kelley
AU - Rowan, Mary
AU - Prinzing, Diane M.
AU - Wynn, Karen
AU - Fallone, Cait
AU - Scorsone, Ann Marie
AU - Wyckoff, Myra H.
AU - Brion, Luc P.
AU - Heyne, Roy J.
AU - Vasil, Diana M.
AU - Adams, Sally S.
AU - Chen, Lijun
AU - De Leon, Maria M.
AU - Eubanks, Frances
AU - Guzman, Alicia
AU - Heyne, Elizabeth T.
AU - Madden, Linda A.
AU - Miller, Nancy A.
AU - Lee, Lizette E.
AU - Pavageau, Lara
AU - Sepulveda, Pollieanna
AU - Boatman, Cathy Twell
AU - Faix, Roger G.
AU - Yoder, Bradley A.
AU - Baserga, Mariana
AU - Osborne, Karen A.
AU - Baker, Shawna
AU - Bird, Karie
AU - Burnett, Jill
AU - Christensen, Susan
AU - Davis, Brandy
AU - Elmont, Jennifer O.
AU - Jensen, Jennifer J.
AU - Loertscher, Manndi C.
AU - Marchant, Trisha
AU - Maxson, Earl
AU - Minton, Stephen D.
AU - Parry, D. Melody
AU - Rau, Carrie A.
AU - Schaefer, Susan T.
AU - Sheffield, Mark J.
AU - Spencer, Cynthia
AU - Steffen, Mike
AU - Weaver-Lewis, Kimberlee
AU - Winter, Sarah
AU - Woodbury, Kathryn D.
AU - Zanetti, Karen
AU - Shankaran, Seetha
AU - Chawla, Sanjay
AU - Sood, Beena G.
AU - Pappas, Athina
AU - Natarajan, Girija
AU - Bajaj, Monika
AU - Bara, Rebecca
AU - Johnson, Mary E.
AU - Goldston, Laura
AU - Wiggins, Stephanie A.
AU - Christensen, Mary K.
AU - Carlson, Martha
AU - Barks, John
AU - White, Diane F.
AU - Ehrenkranz, Richard A.
AU - Jacobs, Harris
AU - Butler, Christine G.
AU - Cervone, Patricia
AU - Greisman, Sheila
AU - Konstantino, Monica
AU - Poulsen, Jo Ann
AU - Taft, Janet
AU - Romano, Elaine
N1 - Publisher Copyright: © 2019 Elsevier Inc.
PY - 2020/4
Y1 - 2020/4
N2 - Objective: To characterize behavior of 2-year-old children based on the severity of bronchopulmonary dysplasia (BPD). Study design: We studied children born at 22-26 weeks of gestation and assessed at 22-26 months of corrected age with the Child Behavior Checklist (CBCL). BPD was classified by the level of respiratory support at 36 weeks of postmenstrual age. CBCL syndrome scales were the primary outcomes. The relationship between BPD grade and behavior was evaluated, adjusting for perinatal confounders. Mediation analysis was performed to evaluate whether cognitive, language, or motor skills mediated the effect of BPD grade on behavior. Results: Of 2310 children, 1208 (52%) had no BPD, 806 (35%) had grade 1 BPD, 177 (8%) had grade 2 BPD, and 119 (5%) had grade 3 BPD. Withdrawn behavior (P < .001) and pervasive developmental problems (P < .001) increased with worsening BPD grade. Sleep problems (P = .008) and aggressive behavior (P = .023) decreased with worsening BPD grade. Children with grade 3 BPD scored 2 points worse for withdrawn behavior and pervasive developmental problems and 2 points better for externalizing problems, sleep problems, and aggressive behavior than children without BPD. Cognitive, language, and motor skills mediated the effect of BPD grade on the attention problems, emotionally reactive, somatic complaints, and withdrawn CBCL syndrome scales (P values < .05). Conclusions: BPD grade was associated with increased risk of withdrawn behavior and pervasive developmental problems but with decreased risk of sleep problems and aggressive behavior. The relationship between BPD and behavior is complex. Cognitive, language, and motor skills mediate the effects of BPD grade on some problem behaviors.
AB - Objective: To characterize behavior of 2-year-old children based on the severity of bronchopulmonary dysplasia (BPD). Study design: We studied children born at 22-26 weeks of gestation and assessed at 22-26 months of corrected age with the Child Behavior Checklist (CBCL). BPD was classified by the level of respiratory support at 36 weeks of postmenstrual age. CBCL syndrome scales were the primary outcomes. The relationship between BPD grade and behavior was evaluated, adjusting for perinatal confounders. Mediation analysis was performed to evaluate whether cognitive, language, or motor skills mediated the effect of BPD grade on behavior. Results: Of 2310 children, 1208 (52%) had no BPD, 806 (35%) had grade 1 BPD, 177 (8%) had grade 2 BPD, and 119 (5%) had grade 3 BPD. Withdrawn behavior (P < .001) and pervasive developmental problems (P < .001) increased with worsening BPD grade. Sleep problems (P = .008) and aggressive behavior (P = .023) decreased with worsening BPD grade. Children with grade 3 BPD scored 2 points worse for withdrawn behavior and pervasive developmental problems and 2 points better for externalizing problems, sleep problems, and aggressive behavior than children without BPD. Cognitive, language, and motor skills mediated the effect of BPD grade on the attention problems, emotionally reactive, somatic complaints, and withdrawn CBCL syndrome scales (P values < .05). Conclusions: BPD grade was associated with increased risk of withdrawn behavior and pervasive developmental problems but with decreased risk of sleep problems and aggressive behavior. The relationship between BPD and behavior is complex. Cognitive, language, and motor skills mediate the effects of BPD grade on some problem behaviors.
KW - BPD
KW - bayley scales of infant and toddler development
KW - child behavior checklist
KW - cognitive
KW - infants born premature
KW - language
KW - motor
UR - http://www.scopus.com/inward/record.url?scp=85078769567&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2019.12.028
DO - 10.1016/j.jpeds.2019.12.028
M3 - Article
C2 - 32008764
AN - SCOPUS:85078769567
SN - 0022-3476
VL - 219
SP - 152-159.e5
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -