Author:
Wang Lian,Lin Xin-Zhu,Shen Wei,Wu Fan,Mao Jian,Liu Ling,Chang Yan-Mei,Zhang Rong,Ye Xiu-Zhen,Qiu Yin-Ping,Ma Li,Cheng Rui,Wu Hui,Chen Dong-Mei,Chen Ling,Xu Ping,Mei Hua,Wang San-Nan,Xu Fa-Lin,Ju Rong,Zheng Zhi,Tong Xiao-Mei,Wang Lian,Lin Xin-Zhu,Shen Wei,Zheng Zhi,Wu Fan,Mao Jian,Liu Ling,Chang Yan-Mei,Tong Xiao-Mei,Zhang Rong,Ye Xiu-Zhen,Qiu Yin-Ping,Ma Li,Cheng Rui,Wu Hui,Chen Dong-Mei,Chen Ling,Xu Ping,Mei Hua,Wang San-Nan,Xu Fa-Lin,Ju Rong,Li Gui-Nan,Li Long,Zhang Zhe,Bei Fei,Deng Chun,Su Ping,Luo Ling-Ying,Liu Xiao-Hong,Wang Li-Jun,Yu Shu-Qun,
Abstract
Abstract
Objective
Nutritional deficiency soon after birth is a risk factor of chronic lung disease (bronchopulmonary dysplasia, BPD). Afflicted infants are further prone to inadequate growth during hospitalization (extrauterine growth restriction, EUGR). This multi-center retrospective study investigated risk factors of EUGR, specifically in very preterm infants with BPD.
Method
Data of infants with BPD who were born less than 32 weeks gestation (n = 1010) were collected from 7 regions of China. All infants were non-small for gestational age at birth. Infants were characterized as EUGR or non-EUGR at 36 weeks gestation or discharge, or stratified by gestational age or birthweight. Logistic regression analysis was applied.
Results
In 65.5% of the population, the BPD was mild. Infants with severe BPD (8.3%) had the highest rate of EUGR (72.6%, P < 0.001). Groups stratified by gestational age did not differ in rates of EUGR, but the birthweight of the EUGR group was significantly lower than that of the non-EUGR (P < 0.001). Birthweights of < 1000, 1000–1499, and ≥ 1500 g showed EUGR rates of 65.9%, 43.4%, and 23.8%, respectively (P < 0.001). Overall, the independent risk factors of EUGR were: moderate-to-severe BPD, gestational hypertension, cesarean section, cumulative fasting time, time required to achieve 110 kcal/kg/d, and hemodynamically significant patent ductus arteriosus (hsPDA).
Conclusion
In very preterm infants with BPD, the lower the birthweight or the more severe the BPD, the greater the risk of EUGR. In those with hsPDA, or moderate-to-severe BPD, it is especially important to prevent EUGR through perinatal management, enteral nutrition, and nutritional strategies.
Funder
Guidance Project of Xiamen Medical and Health in 2019
Guidance Project of Xiamen Medical and Health in 2021
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
Reference30 articles.
1. Wu YL, Lu H, Zhang ZQ. Research progress on the relationship between nutrition and bronchopulmonary dysplasia. Chin J Neonatol. 2020;35(2):148–52.
2. Zhang QS. Active nutrition interventions for extremely preterm infants with bronchopulmonary dysplasia. Chin J Perinatal Med. 2018;21(10):662–7.
3. Cheong JLY, Doyle LW. An update on pulmonary and neurodevelopmental outcomes of bronchopulmonary dysplasia. Semin Perinatol. 2018;42(7):478–84.
4. Wei HL, Xing Y, Wu H, Han TY, Tong XM, Zhou W, et al. Prognosis of bronchopulmonary dysplasia in preterm infants: a follow-up during infancy. Zhongguo Dang Dai Er Ke Za Zhi. 2019;21(7):624–8.
5. Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr. 2016;10:67–83.