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Bronchopulmonary dysplasia and postnatal growth in extremely premature black infants
M E Bozynski1, J M Albert, U Vasan
1University of Michigan Medical Center, Department of Pediatrics, Ann Arbor 48109/0254.
Insights
Bronchopulmonary dysplasia (BPD) in premature infants does not significantly impact postnatal growth when birth weight is controlled. Birth weight, not BPD, is the primary factor influencing growth patterns in these infants.
Area of Science:
- Neonatology
- Pediatric Growth Studies
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in extremely premature infants.
- Existing research on BPD's effect on infant growth often lacks control for birth weight.
- Postnatal growth trajectories in premature infants are complex and influenced by multiple factors.
Purpose of the Study:
- To investigate the impact of bronchopulmonary dysplasia (BPD) on the postnatal growth of extremely premature infants.
- To determine if BPD independently affects growth patterns after controlling for birth weight and other variables.
- To identify factors influencing growth from birth to 12 months corrected age in premature infants.
Main Methods:
- Studied 90 Black premature infants, analyzing weight biweekly until discharge and at 4, 8, and 12 months corrected age.
- Utilized the Count model to analyze growth in two stages: birth to term (Stage I) and term to 12 months (Stage II).
- Employed multivariate analyses to control for BPD, birth weight, gestational age, hospitalization duration, and socioeconomic status.
Main Results:
- After adjusting for birth weight, BPD did not significantly explain the observed postnatal growth patterns.
- Lower gestational age was linked to a delayed establishment of steady growth (P < 0.01).
- Longer hospitalization duration correlated with a reduced growth rate (P < 0.05).
- Catch-up growth was observed in both infants with and without BPD.
- Growth in Stage II (term to 12 months) was not explained by the studied variables.
Conclusions:
- Birth weight is the primary determinant of growth differences among premature infants, including those with BPD.
- BPD itself does not appear to be the main driver of altered growth when birth weight is accounted for.
- Severe BPD may be associated with poorer growth in a subset of infants, warranting further investigation.
Abstract:
Bronchopulmonary dysplasia (BPD) may adversely affect the postnatal growth of the extremely premature infant; however, most studies have not controlled for birth weight. We studied 90 Black premature infants (mean birth weight 989 +/- 148 g). Weight was recorded biweekly until discharge and at 4, 8, and 12 months of age corrected for prematurity. Infants with BPD (N = 23) were contrasted with infants without BPD (N = 67). Data were modeled using the Count model: Stage I birth to term and Stage II term to 12 months. Birth weight was considered part of growth beginning in utero and multivariate analyses were used to control for BPD, gestational age, duration of hospitalization and socioeconomic status. After adjustment for birth weight, BPD did not explain the growth pattern. A lower gestational age was associated with a slower establishment of steady growth (P less than 0.01), while an increased duration of hospitalization was associated with a lower growth rate (P less than 0.05). Growth in stage II was not explained by study variables. 'Catch-up' growth was seen in both infants with and without BPD. We conclude that differences in growth among infants with BPD are mainly attributable to birth weight. We speculate that poorer growth may be seen in a sub-group of infants with severe BPD.