Risk factors of extrauterine growth retardation in very preterm infants with bronchopulmonary dysplasia
10.3760/cma.j.issn.2096-2932.2022.03.004
- VernacularTitle:支气管肺发育不良极早产儿宫外生长迟缓影响因素分析
- Author:
Yasen WANG
1
;
Wei SHEN
;
Lixia TANG
;
Qing YANG
;
Xinzhu LIN
Author Information
1. 厦门大学附属妇女儿童医院（厦门市妇幼保健院）新生儿科，厦门市围产-新生儿感染重点实验室，厦门 361003
- Keywords:
Bronchopulmonary dysplasia;
Extrauterine growth retardation;
Very preterm infants;
Nutrition;
Risk factors
- From:Chinese Journal of Neonatology
2022;37(3):208-213
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the nutritional status of very preterm infants (VPIs) with bronchopulmonary dysplasia (BPD) during hospitalization and the risk factors of extrauterine growth retardation (EUGR).Methods:From January 2017 to June 2020, clinical data of VPIs with BPD hospitalized in the department of neonatology of our hospital were retrospectively studied. The infants were assigned into EUGR group and non-EUGR group and their nutritional status and the risk factors of EUGR were compared.Results:A total of 225 VPIs were enrolled, including 143 cases of EUGR (63.6%) and 82 non-EUGR (36.4%). The EUGR group had significantly lower birth weight (BW) than non-EUGR group ( P<0.001). No significant difference existed in the gestational age (GA) between the two groups ( P=0.733). The incidences of EUGR in VPIs with mild, moderate and severe BPD were 41.9%, 70.8% and 90.7%, respectively and the differences were statistically significant ( P<0.001). Compared with non-EUGR group, EUGR group received less full-course antenatal corticosteroids (47.6% vs. 63.4%, P=0.022). EUGR group had longer duration of parenteral nutrition, fasting time and achieving full enteral nutrition ( P<0.05). EUGR group also showed slower increment of enteral feed volumes, slower growth velocity and higher incidence of feeding intolerance ( P<0.05). Multivariate logistic regression analysis showed that moderate/severe BPD, BW <1 000 g and feeding intolerance were independent risk factors for EUGR in VPIs. The use of pulmonary surfactant at birth was a predictive factor for EUGR in VPIs with BPD. Growth velocity >13 g/(kg·d) and full-course of antenatal corticosteroids were protective factors of EUGR for BPD infants. Conclusions:It is necessary to improve the use of full-course antenatal corticosteroids to reduce the application of pulmonary surfactant at birth in VPIs. Better enteral nutrition and improved growth velocity will help reducing the incidence of EUGR in VPIs with BPD.
