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Risk factors of extrauterine growth restriction in very preterm infants with bronchopulmonary dysplasia: a multi-center study in China

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单位: [1]Xiamen Univ, Women & Childrens Hosp, Sch Med, Dept Neonatol, Xiamen, Peoples R China [2]Xiamen Key Lab Perinatal Neonatal Infect, Xiamen, Peoples R China [3]Guangzhou Med Univ, Affiliated Hosp 3, Dept Neonatol, Guangzhou, Peoples R China [4]China Med Univ, Dept Pediat, Shengjing Hosp, Shenyang, Peoples R China [5]Guiyang Childrens Hosp, Guiyang Maternal & Child Hlth Hosp, Dept Neonatol, Guiyang, Peoples R China [6]Peking Univ Third Hosp, Dept Pediat, Beijing, Peoples R China [7]Fudan Univ, Dept Neonatol, Childrens Hosp, Shanghai, Peoples R China [8]Guangdong Prov Maternal & Childrens Hosp, Dept Neonatol, Guangzhou, Peoples R China [9]Ningxia Med Univ, Dept Neonatol, Gen Hosp, Yinchuan, Ningxia, Peoples R China [10]Childrens Hosp Hebei Prov, Dept Neonatol, Shijiazhuang, Hebei, Peoples R China [11]Nanjing Med Univ, Children Hosp, Dept Neonatol, Nanjing, Peoples R China [12]First Hosp Jilin Univ, Dept Neonatol, Changchun, Peoples R China [13]Quanzhou Matern & Childrens Hosp, Dept Neonatol, Quanzhou, Peoples R China [14]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Pediat, Wuhan, Peoples R China [15]Liaocheng Peoples Hosp, Dept Neonatol, Liaocheng, Shandong, Peoples R China [16]Inner Mongolia Med Univ, Dept Neonatol, Affiliate Hosp, Hohhot, Peoples R China [17]Suzhou Municipal Hosp, Dept Neonatol, Suzhou, Peoples R China [18]Zhengzhou Univ, Affiliated Hosp 3, Dept Neonatol, Zhengzhou, Peoples R China [19]Univ Elect Sci & Technol China, Chengdu Women & Childrens Cent Hosp, Sch Med, Dept Neonatol, Chengdu, Peoples R China
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关键词: Bronchopulmonary dysplasia Very preterm infants Perinatal nutrition Extrauterine growth restriction

摘要:
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.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 3 区 儿科
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大类 | 3 区 医学
小类 | 3 区 儿科
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Q3 PEDIATRICS
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Q2 PEDIATRICS

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第一作者单位: [1]Xiamen Univ, Women & Childrens Hosp, Sch Med, Dept Neonatol, Xiamen, Peoples R China [2]Xiamen Key Lab Perinatal Neonatal Infect, Xiamen, Peoples R China
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