NEURODEVELOPMENT OUTCOMES IN PRETERM INFANTS WITH CHRONIC LUNG DISEASE

Abstract

Preterm birth remains a significant contributor to neonatal morbidity and long-term neurodevelopmental impairment, particularly in infants diagnosed with chronic lung disease (CLD). This study aimed to investigate the relationship between CLD and neurodevelopmental outcomes in preterm infants born at less than 32 weeks of gestation. Utilizing a retrospective cohort design, we analyzed data from a tertiary neonatal intensive care unit, focusing on developmental assessments conducted at 18–24 months corrected age. Infants with CLD demonstrated significantly lower mean scores across cognitive (85 vs. 93), language (80 vs. 88), and motor (78 vs. 90) domains on the Bayley-III scales compared to those without CLD (p < 0.005 across domains). Furthermore, the incidence of adverse neurological outcomes such as cerebral palsy (18% vs. 8%), behavioral disorders (25% vs. 12%), and sensory impairments was markedly higher in the CLD group. Neuroimaging revealed an increased prevalence of white matter injury, cerebellar hemorrhage, and delayed myelination in CLD-affected infants. Multivariate logistic regression analysis identified CLD as a strong independent predictor of poor neurodevelopmental outcomes, with an adjusted odds ratio of 2.8 (95% CI: 1.6–5.2, p < 0.001), even after accounting for gestational age, sepsis, and intraventricular hemorrhage. These findings underscore the systemic impact of CLD beyond respiratory morbidity, particularly its influence on cerebral development during a critical period of brain maturation. The study highlights the importance of early identification and interdisciplinary management of high-risk preterm infants to mitigate long-term cognitive and behavioral deficits. Ultimately, this research advances our understanding of the pathophysiological link between pulmonary and neurological outcomes and emphasizes the need for integrated neonatal care strategies.