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Improved weight attainment of extremely low-gestational-age infants with bronchopulmonary dysplasia

J Madden1, K Kobaly, N M Minich

  • 1Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|October 3, 2009
PubMed

Insights

Improved weight z-scores were observed in infants with bronchopulmonary dysplasia (BPD) after 2000, but poor growth remains a significant issue. This study highlights changes in neonatal care and their impact on infant development.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Growth and Development

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
  • Growth attainment is a critical outcome measure for infants with BPD.
  • Changes in neonatal intensive care unit (NICU) practices may influence BPD outcomes.

Purpose of the Study:

  • To evaluate the impact of evolving neonatal practices on the growth of infants with BPD since the year 2000.
  • To assess changes in morbidity and their correlation with growth outcomes in this vulnerable population.

Main Methods:

  • A comparative study design was employed, analyzing extremely low-gestational-age infants (<28 weeks) with BPD.
  • Infant anthropometric z-scores (weight, length, head circumference) were compared at birth, 40 weeks, and 20 months corrected age (CA) between two periods: 1996-1999 and 2000-2003.
  • The influence of neonatal practice changes, morbidities, and neurosensory outcomes on 20-month growth was examined.

Main Results:

  • Infants in the 2000-2003 period showed significantly improved mean weight z-scores and reduced rates of subnormal weight at 20 months CA compared to the earlier period (P<0.05).
  • No significant improvements were observed in length or head circumference z-scores between the two periods.
  • Key predictors of 20-month weight z-score included the time period, duration of ventilator dependence, and presence of neurosensory abnormalities (P<0.05).

Conclusions:

  • While weight gain has improved in infants with BPD since 2000, suboptimal growth persists as a significant clinical challenge.
  • Continued monitoring and intervention are necessary to address the multifaceted issues affecting growth in BPD survivors.
Abstract

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