Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The influence of small for gestational age status on outpatient bronchopulmonary dysplasia outcomes

Journal of Perinatology volume 35, pages 72–76 (2015)Cite this article

Subjects

Abstract

Objective:

To describe the characteristics of small for gestational age (SGA) and non-SGA infants with bronchopulmonary dysplasia (BPD) and to ascertain whether respiratory outcomes and health-care utilization patterns in these two populations differ.

Study Design:

Three hundred and twenty-five infants with BPD born at <32 weeks gestation were recruited in the outpatient setting. Sociodemographic data and indicators of respiratory morbidity were collected via questionnaire and retrospective chart review.

Result:

SGA infants were on average 1 month older than non-SGA infants at discharge from the neonatal intensive care unit and were more likely to have a weight less than 10th percentile at first clinic visit. History of SGA was associated with increased risk of emergency department visits as well as with caregiver perception of poor weight gain.

Conclusion:

SGA status in infants with BPD is associated with increased health-care utilization, including length of initial hospitalization and emergency department visits.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Horbar JD, Badger GJ, Carpenter JH, Fanaroff AA, Kilpatrick S, LaCorte M, et al. Trends in mortality and morbidity for very low birth weight infants, 1991–1999. Pediatrics 2002; 110 (1): 143–151.

    Article  Google Scholar 

  2. Berger TM, Bachmann II, Adams M, Schubiger G . Impact of improved survival of very low-birthweight infants on incidence and severity of bronchopulmonary dysplasia. Biol Neonate 2004; 86 (2): 124–130.

    Article  Google Scholar 

  3. Northway WH, Rosan RC, Porter DY . Pulmonary disease following respiratory therapy of hyaline membrane disease: bronchopulmonary dysplasia. N Engl J Med 1967; 276: 357–368.

    Article  Google Scholar 

  4. Regev RH, Reichman B . Prematurity and intrauterine growth retardation—double jeopardy? Clin Perinatol 2004; 453–473.

    Article  Google Scholar 

  5. Jobe AH, Bancalari E . NICHD/NHLBI/ORD Workshop Summary: Bronchopulmonary Dysplasia. Am J Respir Crit Care Med 2001; 163: 1723–1729.

    Article  CAS  Google Scholar 

  6. Ehrenkranz RA, Walsh MC, Vohr BR, Jobe AH, Wright LL, Fanaroff AA, et al. Validation of the National Institutes of Health Consensus Definition of Bronchopulmonary Dysplasia. Pediatrics 2005; 116 (6): 1353–1360.

    Article  Google Scholar 

  7. Lal MK, Manktelow BN, Draper ES, Field DJ . Chronic lung disease of prematurity and intrauterine growth retardation: a population-based study. Pediatrics 2003; 111 (3): 483–487.

    Article  Google Scholar 

  8. Egreteau L, Pauchard JY, Semama DS, Matis J, Liska A, Romeo B, et al. Chronic oxygen dependency in infants born at less than 32 weeks’ gestation: incidence and risk factors. Pediatrics 2001; 108 (2): E26.

    Article  CAS  Google Scholar 

  9. Cooke RW . Conventional birth weight standards obscure fetal growth restriction in preterm infants. Arch Dis Child Fetal Neonatal Ed 2007; 92: F189.

    Article  Google Scholar 

  10. Joyce BJ, Louey S, Davey MG, Cock ML, Hooper SB, Harding R . Compromised respiratory function in postnatal lambs after placental insufficiency and intrauterine growth restriction. Pediatr Res 2001; 50 (5): 641–649.

    Article  CAS  Google Scholar 

  11. Maritz GS, Cock ML, Louey S, Suzuki K, Harding R . Fetal growth restriction has long-term effects on postnatal lung structure in sheep. Pediatr Res 2004; 55 (2): 287–295.

    Article  Google Scholar 

  12. Rozance PJ, Seedorf GJ, Brown A, Roe G, O’Meara MC, Gien J, et al. Intrauterine growth restriction decreases pulmonary alveolar and vessel growth and causes pulmonary artery endothelial cell dysfunction in vitro in fetal sheep. Am J Physiol Lung Cell Mol Physiol 2011; 301: L860–L871.

    Article  CAS  Google Scholar 

  13. Bose C, Van Marter LJ, Laughon M, O’Shea TM, Allred EN, Karna P, et al. Fetal growth restriction and chronic lung disease among infants born before the 28th week of gestation. Pediatrics 2009; 124 (3): e450–e458.

    Article  Google Scholar 

  14. Klinger G, Sirota L, Lusky A, Reichman B . Bronchopulmonary dysplasia in very low birth weight infants is associated with prolonged hospital stay. J Perinatol 2006; 26: 640–644.

    Article  CAS  Google Scholar 

  15. Greenough A, Limb E, Marston L, Marlow N, Calvert S, Peacock J . Risk factors for respiratory morbidity in infancy after very premature birth. Arch Dis Child Fetal Neonatal Ed 2005; 90: F320–F323.

    Article  CAS  Google Scholar 

  16. Greenough A, Cox S, Alexander J, Lenney W, Turnbull F, Burgess S, et al. Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection. Arch Dis Child 2001; 85: 463–468.

    Article  CAS  Google Scholar 

  17. Oken E, Kleinman KP, Rich-Edwards J, Gillman MW . A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr 2003; 3: 6.

    Article  Google Scholar 

  18. Wang LY, Luo HJ, Hsieh WS, Hsu CH, Hsu HC, Chen PS, et al. Severity of bronchopulmonary dysplasia and increased risk of feeding desaturation and growth delay in very low birth weight preterm infants. Pediatr Pulmonol 2010; 45: 165–173.

    Article  Google Scholar 

  19. Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A . Morbidity and mortality among very-low-birthweight neonates with intrauterine growth restriction. Am J Obstet Gynecol 2000; 182 (1,part 1): 198–206.

    Article  CAS  Google Scholar 

  20. Padula MA, Grover TR, Brozanski B, Zaniletti I, Nelin LD, Asselin JM, et al. Therapeutic interventions and short-term outcomes for infants with severe bronchopulmonary dysplasia born at &lt;32 weeks’ gestation. J Perinatol 2013; 33(11): 877–881.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was funded by the Thomas Wilson Foundation, the Flight Attendant Medical Research Institute and the American Academy of Pediatrics Julius B Richmond Center. We thank the patients and families who participated in this study.

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    J Johnson

  2. Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    T Ryan, A D Aherrera, S A McGrath-Morrow & J M Collaco

Authors
  1. J Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Ryan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A D Aherrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S A McGrath-Morrow
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J M Collaco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J M Collaco.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Johnson, J., Ryan, T., Aherrera, A. et al. The influence of small for gestational age status on outpatient bronchopulmonary dysplasia outcomes. J Perinatol 35, 72–76 (2015). https://doi.org/10.1038/jp.2014.142

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2014.142

Search

Advanced search

Quick links