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Impaired growth at birth and bronchopulmonary dysplasia classification: beyond small for gestational age

Michael F Nyp1, Jane B Taylor1, Michael Norberg1

  • 1Department of Pediatrics, Center for Infant Pulmonary Disorders, The Children's Mercy Hospital, Kansas City, Missouri.

American Journal of Perinatology
|May 20, 2014
PubMed

Insights

Infants born before 26 weeks gestational age experience significant growth issues and are at higher risk for bronchopulmonary dysplasia (BPD). Lower birth weight for gestational age, beyond standard small-for-gestational age, is linked to moderate/severe BPD.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Growth and Development

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
  • Intrauterine and postnatal growth are critical factors influencing preterm infant outcomes.
  • Understanding growth patterns in relation to BPD severity is essential for improving care.

Purpose of the Study:

  • To investigate the correlation between intrauterine and postnatal growth parameters and the classification of bronchopulmonary dysplasia (BPD) at 36 weeks postmenstrual age (PMA).
  • To identify growth-related risk factors for BPD in extremely preterm infants.

Main Methods:

  • Retrospective cohort study of infants born before 29 weeks gestational age (GA) between 2008 and 2010.
  • BPD classification based on physiological definition at 36 weeks PMA.
  • Comparison of growth parameters (birth weight, length, head circumference) at birth and 36 weeks PMA across different GA subgroups.

Main Results:

  • A cohort of 140 infants was analyzed, with a median GA of 27 weeks.
  • BPD prevalence: 20% no BPD, 27% mild, 31% moderate, 22% severe.
  • Infants born <26 weeks GA showed impaired linear and head circumference growth postnatally. All infants <26 weeks GA below the 25th percentile for weight developed moderate/severe BPD.

Conclusions:

  • Extremely preterm infants (<26 weeks GA) exhibit smaller birth size and significant postnatal growth deficits.
  • Lower birth weight for GA, even beyond the typical small-for-gestational age (SGA) definition, is associated with an increased risk of developing moderate to severe BPD.
Abstract

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