Association between nutrient intake and bronchopulmonary dysplasia in extremely preterm infants

Abstract

Abstract Objective bronchopulmonary dysplasia (BPD) is a common chronic lung disease in preterm infants, and nutrition is an important factor in the prevention and treatment of BPD. To investigate the association between early nutritional intake after birth and bronchopulmonary dysplasia (BPD) in very preterm infants with gestational age (GA) ≤ 32 weeks. Methods A retrospective case-control study was conducted. The subjects were preterm infants with gestational age ≤ 32 weeks admitted to the Neonatal intensive Care Unit of Hebei General Hospital from December 1, 2018 to December 1, 2022. A total of 195 infants who met the criteria were enrolled and divided into BPD group and non-BPD group according to their clinical manifestations. Results A total of 195 preterm infants were enrolled in this study, including 85 cases in BPD group and 110 cases in non-BPD group. (1)Compared with the non-BPD group, the gestational age, birth weight, and delivery of BPD group were significantly higher Birth length, head circumference, and cesarean section rate were lower in the BPD group than in the non-BPD group (P < 0.05). The BPD group had a higher total fluid volume than the non-BPD group on the fourth day after birth(P < 0.05); Compared with the non-BPD group, the BPD group had significantly lower total caloric intake on days 4, 7, and 14, intestinal fluid volume on days 4, 7, and 14, intestinal caloric intake on days 4, 7, and 14, protein on days 4, 7, and 14, fat emulsion on days 4, 7, and 14, and carbohydrate on days 14(P < 0.05). The initiation time of breastfeeding in BPD group was later than that in non-BPD group(P < 0.05).(2)Binary logistic regression analysis showed that total fluid volume on day 4 and duration of non-invasive mechanical ventilation were independent risk factors for BPD in very preterm infants; Intestinal energy and protein on day 7 are protective factors for BPD in very preterm infants. Conclusion The occurrence of BPD in very preterm infants is the result of multiple factors. It is helpful to reduce the incidence of BPD by limiting the total fluid intake on the fourth day, increasing the intake of enteral fluid and enteral calorie, starting breastfeeding as early as possible, and increasing the intake of protein, fat emulsion and calorie on the fourth, seventh and fourteenth days.