Original Article

Journal of Perinatology (2006) 26, 428–435. doi:10.1038/sj.jp.7211538; published online 18 May 2006

Site-specific characteristics of infants developing bronchopulmonary dysplasia

M Akram Khan1,3,4, B Kuzma-O'Reilly2,3, N L Brodsky1,5 and V Bhandari1

  1. 1Division of Neonatology, Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, PA, USA
  2. 2Mercy Children's Hospital, Toledo, OH, USA

Correspondence: Dr V Bhandari, Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, LCI 401B; PO Box 208064, New Haven, CT 06520-8064, USA. E-mail: vineet.bhandari@yale.edu

3These two authors contributed equally to this work.

4Current address: Division of Neonatolgy, University of South Dakota, Sioux Falls, SD, USA.

5Current address: Division of Neonatolgy, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Received 20 February 2006; Revised 11 April 2006; Accepted 17 April 2006; Published online 18 May 2006.

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Abstract

Hypothesis:

 

Site-specific variables that contribute to the pathogenesis of bronchopulmonary dysplasia (BPD) can be identified.

Objectives:

 

To evaluate the demographic, nutrition and growth characteristics of infants at risk for developing BPD at two neonatal intensive care units (NICUs: sites A and O).

Study Design:

 

Records of 306 infants of <30 weeks gestational age (GA) who survived to at least 36 weeks postmenstrual age were retrospectively reviewed. Data were obtained for maternal and neonatal demographics, weights, total fluids, calories, carbohydrate, protein and fat intake at birth, 7, 14, 21 and 28 days of life.

Results:

 

BPD rates were not different at the two sites. No statistical differences were noted in the incidence of maternal chorioamnionitis, pregnancy-induced hypertension or use of antenatal steroids among infants who developed BPD (n=169) and those who did not (n=137). White race, birth weight, respiratory distress syndrome requiring surfactant, sepsis and patent ductus arteriosus were significantly associated (all Pless than or equal to0.03) with BPD. After controlling for significant confounding variables, infants who developed BPD had significantly (P<0.001) less weight gain, received less calories and fat in the first postnatal month. In the 26 to 28 weeks GA group, the odds of getting BPD were 5.4 (95%CI: 1.4 to 21.3) times greater for site A than site O (P=0.017).

Conclusion:

 

Our analysis suggests that while some decrease in BPD can be achieved by focusing on ventilation/oxygen use, this approach is unlikely to impact on the youngest infants.

Keywords:

preterm neonate, respiratory distress syndrome, nutrition, lipids

Abbreviations:

BW, birth weight; BPD, bronchopulmonary dysplasia; GA, gestational age; IVH, intraventricular hemorrhage; NEC, necrotizing enterocolitis; PMA, postmenstrual age; PDA, patent ductus arteriosus; PIH, pregnancy-induced hypertension; PNS, postnatal steroids; PVL, periventricular leukomalacia; RDS, respiratory distress syndrome; TPN, total parenteral nutrition

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