Executive functioning deficits in young adult survivors of bronchopulmonary dysplasia

Abstract

Purpose: To assess long-term impairments of executive functioning in adult survivors of bronchopulmonary dysplasia (BPD). Method: Participants were assessed on measures of executive functioning, health-related quality of life (HRQoL) and social functioning. Survivors of BPD (n = 63; 34 males; mean age 24.2 years) were compared with groups comprising preterm (without BPD) (<1500 g; n = 45) and full-term controls (n = 63). Analysis of variance was used to explore differences among groups for outcome measures. Multiple regression analyzes were performed to identify factors predictive of long-term outcomes. Results: Significantly more BPD adults, compared with preterm and term controls, showed deficits in executive functioning relating to problem solving (OR: 5.1, CI: 1.4–19.3), awareness of behavior (OR: 12.7, CI: 1.5–106.4) and organization of their environment (OR: 13.0, CI: 1.6–107.1). Birth weight, HRQoL and social functioning were predictive of deficits in executive functioning. Conclusions: This study represents the largest sample of survivors into adulthood of BPD and is the first to show that deficits in executive functioning persist. Children with BPD should be assessed to identify cognitive impairments and allow early intervention aimed at ameliorating their effects.

Implications for Rehabilitation

• Adults born preterm with very-low birth weight, and particularly those who develop BPD, are at increased risk of exhibiting defects in executive functioning.

• Clinicians and educators should be made aware of the impact that BPD can have on the long-term development of executive functions.

• Children and young adults identified as having BPD should be periodically monitored to identify the need for possible intervention.

• Bronchopulmonary dysplasia
• executive functioning
• health-related quality of life
• social functioning
• very-low birth weight

Declaration of interest

All authors report no declarations of interest relevant to the submission of this manuscript.

This research was supported by funding from The Research Forum for the Child, Queen’s University Belfast; The Friends of Jessica Trust; The Northern Ireland Chest, Heart and Stroke Association and the Perinatal Trust Fund, Royal Victoria Hospital. No sponsor had involvement with the study design, collection, analysis or interpretation of the data, writing the manuscript or with the decision to submit the work for publication. A. G. wrote the first draft of the manuscript as part of a PhD studentship. All other authors contributed to the drafting and approval of the final manuscript.