Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Jun 24;22(1):363.
doi: 10.1186/s12887-022-03405-z.

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

Lian Wang #  1   2 , Xin-Zhu Lin #  1   2 , Wei Shen  1   2 , Fan Wu  3 , Jian Mao  4 , Ling Liu  5 , Yan-Mei Chang  6 , Rong Zhang  7 , Xiu-Zhen Ye  8 , Yin-Ping Qiu  9 , Li Ma  10 , Rui Cheng  11 , Hui Wu  12 , Dong-Mei Chen  13 , Ling Chen  14 , Ping Xu  15 , Hua Mei  16 , San-Nan Wang  17 , Fa-Lin Xu  18 , Rong Ju  19 , Zhi Zheng  1   2 , Xiao-Mei Tong  20 ; Chinese Multicenter EUGR Collaborative Group
Collaborators, Affiliations
Multicenter Study

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

Lian Wang et al. BMC Pediatr. .

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.

Keywords: Bronchopulmonary dysplasia; Extrauterine growth restriction; Perinatal nutrition; Very preterm infants.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest.

References

    1. Wu YL, Lu H, Zhang ZQ. Research progress on the relationship between nutrition and bronchopulmonary dysplasia. Chin J Neonatol. 2020;35(2):148–152.
    1. Zhang QS. Active nutrition interventions for extremely preterm infants with bronchopulmonary dysplasia. Chin J Perinatal Med. 2018;21(10):662–667.
    1. Cheong JLY, Doyle LW. An update on pulmonary and neurodevelopmental outcomes of bronchopulmonary dysplasia. Semin Perinatol. 2018;42(7):478–484. doi: 10.1053/j.semperi.2018.09.013. - DOI - PubMed
    1. 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):624–628. - PMC - PubMed
    1. Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr. 2016;10:67–83. - PMC - PubMed

Publication types