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Growth and body composition in preterm infants with bronchopulmonary dysplasia
W A Huysman1, M de Ridder, N C de Bruin
1Department of Pediatrics, Division of Neonatology, Sophia Children's Hospital, Rotterdam, The Netherlands. huysman@alkg.azr.nl
Insights
Preterm infants with bronchopulmonary dysplasia (BPD) show impaired growth and body composition, with deficits in total body fat and free fat mass evident early and persisting through the first year. Further research into nutritional interventions is recommended.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Nutritional Science
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Growth and body composition in infants with BPD are not well understood compared to healthy term infants.
Purpose of the Study:
- To compare the growth and body composition of preterm infants with BPD to healthy term infants during the first year of life.
Main Methods:
- Prospective follow-up of 29 preterm infants with BPD.
- Measurements included anthropometry and body composition via total body electrical conductivity.
- Comparison group: healthy term infants matched for post-term age.
Main Results:
- Infants with BPD exhibited significantly lower weight, length, free fat mass (FFM), and total body fat (TBF) standard deviation scores compared to healthy term infants.
- These deficits were evident as early as 6 weeks post-term and persisted throughout the first year of life.
- While length improved, it remained below average for girls with BPD at 12 months.
Conclusions:
- Preterm infants with BPD experience significant growth impairment and body composition deficits (TBF and FFM) from early infancy.
- The persistent low levels of FFM and TBF suggest a need for nutritional intervention studies.
- Investigating whether nutrition or disturbed endocrine control is the primary driver of these growth patterns is warranted.
Objective:
To compare growth and body composition in preterm infants with bronchopulmonary dysplasia (BPD) with normal healthy term infants during the first year of life.
Design:
Twenty nine preterm infants with BPD (mean (SD) gestational age 27.1 (1.6) weeks; birth weight 852 (173) g) were followed prospectively. Anthropometry and body composition determined by total body electrical conductivity were measured and compared with those of healthy term infants at the same post-term age.
Results:
In infants with BPD, the mean weight standard deviation scores (SD scores) 6 weeks after term were significantly lower (-1.44 and -2.68, boys and girls respectively) than in healthy term infants of the same age and did not improve during the first year. The mean length SD score was significantly lower in infants with BPD 6 weeks after term than in healthy term infants of the same age, and, although it improved significantly during the first year, the mean length SD score in girls with BPD was significantly below 0 12 months after term. In infants with BPD, the mean free fat mass (FFM) SD score and the mean total body fat (TBF) SD score at 6 weeks post-term age were significantly below 0. The mean FFM SD scores (-1.01 and -2.56, boys and girls respectively) and the mean TBF SD scores (-1.14 and -2.40, boys and girls respectively) 12 months after term were significantly lower than in healthy term infants of the same age.
Conclusions:
Preterm infants with BPD have impaired growth, with a deficit in TBF and FFM already 6 weeks after term; FFM and TBF remain low compared with healthy term infants during the first year of life. Nutritional intervention studies in infants with BPD are needed to evaluate if nutrition is the major determinant of growth and body composition or if this pattern of growth in preterm infants with BPD is the result of disturbed endocrine control.