Respiratory and non-respiratory outcomes of bronchopulmonary dysplasia in adolescents: A systematic review

Abstract

Background: There is lack of evidence synthesis on the global consequences of bronchopulmonary dysplasia (BPD) in adolescence. Aim: Assess the impact of bronchopulmonary dysplasia on respiratory and non-respiratory outcomes in adolescents.Methods: A systematic review of studies assessing the outcomes of adolescents aged 10 to 19 years-old with BPD was conducted. We independently screened studies published until 6th March 2023 in PubMed (R) and Scopus (R) databases. Data on methodologic design, sample descriptive and findings were extracted from each study. Risk of bias was assessed using quality assessment tools.Results: Thirty-one studies were included. Adolescents with a history of BPD present with more respiratory symptoms (wheezing, respiratory exacerbations, need for respiratory medication) and twenty-five studies showed a reduction in pulmonary function, with varying impact according to BPD severity and no differences before and after the surfactant era. Spirometry evaluation throughout the years is not consensual, but meth-acholine and salbutamol response in BPD groups is increased compared to non-BPD groups. Markers of eosin-ophilic airway inflammation are not increased as in asthma patients. Exercise potential is identical, but data regarding physical capacity and activity are inconsistent. More frequent radiologic abnormalities translate into higher high-resolution computed tomography scores, with linear (72.2 %) and triangular subpleural opacities (58.3 %) as the most common findings. There is a higher risk for special needs in education, but quality of life seems to be equal to non-BPD adolescents.Conclusions: BPD negatively impacts both pulmonary and non-pulmonary outcomes in adolescents.