CLINICAL, RADIOLOGICAL AND FUNCTIONAL CONSEQUENCES OF BRONCHOPULMONARY DYSPLASIA IN CHILDREN OF PRESCHOOL AND EARLY SCHOOL AGE, DEPENDING ON BIRTH WEIGHT

Advances in medical technology are leading to the survival of very premature infants, who often develop bronchopulmonary dysplasia (BPD). In this regard, the health problem of children with extremely low birth weight (ELBW) and BPD is relevant, since there is insufficient domestic experience in monitoring such patients. The outcomes of the disease among deeply premature infants with ELBW at school age have not been fully studied in comparison with peers with BPD, but born with a greater body weight. Objective of the study: to assess the clinical, radiological and functional consequences of BPD in children of preschool and early school age, depending on body weight at birth. Materials and methods of research: the design of the study – a non-randomized retrospective single-center comparative pilot study. We examined 73 children with a history of BPD, aged from 5 to 8 years (median – 7 years). The boys/girls ratio is 38/35. Children were divided into 2 groups: 1st group – 50 children born with low body weight (LBW) and very low body weight (VLBW), and 2nd group – 23 children with ELBW, most of them had a mild form of the disease. Respiratory symptoms were studied, computed tomography (CT) of the chest organs was performed to assess structural changes and the study of external respiratory function (ERF). Results: 1/3 of children of the 1st and 2nd groups had prolonged episodes of bronchial obstruction. The vast majority of children, regardless of their birth weight, had structural changes in the lungs – 96% of children of the 1st group and 94% of children of the 2nd group, p=0,888. Most often, the results of CT revealed fibrotic changes, collapse/hypoventilation, ventilation inhomogeneity, somewhat less often – emphysema, peribronchial changes, without differences between groups (p>0,05). Children with ELBW had statistically insignificantly less frequent occurrence of the air trap symptom (12% and 26%, p=0,314) compared with children with VLBW and LBW. The study of ERF revealed a decrease in speed indicators, an increase in bronchial resistance and a slight decrease in the diffusion capacity of the lungs in children of both groups without statistically significant differences (p>0,05). Conclusion: children with ELBW who underwent BPD demonstrate persistence of clinical symptoms, structural and functional disorders, like their peers with BPD in anamnesis, but born with a greater body weight.