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Risk factors for metabolic bone disease among preterm infants less than 32 weeks gestation with Bronchopulmonary

Wenwen Chen1, Zhenhai Zhang2, Shuzhen Dai2

  • 1Zhangzhou Hospital Affiliated to Fujian Medical University, Shengli W Rd, Xiangcheng District, Zhangzhou, Fujian, China. pipixiu@163.com.

BMC Pediatrics
|May 18, 2021
PubMed

Insights

Metabolic bone disease (MBD) is common in infants with bronchopulmonary dysplasia (BPD). Risk factors include fetal growth restriction, low birth weight, poor feeding volume, cholestasis, sepsis, and diuretic use.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Critical Care Pediatrics

Background:

  • Infants with bronchopulmonary dysplasia (BPD) exhibit a higher prevalence of metabolic bone disease (MBD).
  • The specific contributing factors to MBD development in BPD infants remain largely undetermined.
  • This study aimed to identify key risk factors for MBD in this vulnerable population.

Purpose of the Study:

  • To investigate and identify significant risk factors associated with the development of metabolic bone disease (MBD) in infants diagnosed with bronchopulmonary dysplasia (BPD).
  • To provide insights into potential predictive markers for MBD in BPD infants.
  • To inform clinical practice and future research directions.

Main Methods:

  • A retrospective analysis of medical records for BPD infants admitted to Zhangzhou Hospital's Neonatal Intensive Care Unit from June 2016 to May 2020.
  • Cases of MBD were identified and matched with controls (BPD infants without MBD) based on gestational age and gender.
  • Statistical analysis, including univariate and multivariate models, was employed to determine the association between various factors and MBD.

Main Results:

  • Fetal growth restriction (OR 6.00), extremely low birth weight (OR 3.10), and feeding volume < 80 mL/kg/d by week 4 (OR 14.98) were significant risk factors.
  • Cholestasis (OR 4.44), late-onset sepsis (OR 3.95), and prolonged diuretic use (> 2 weeks) (OR 5.45) also emerged as significant risk factors for MBD.
  • A total of 156 infants were analyzed, with 52 cases of MBD and 104 controls.

Conclusions:

  • Fetal growth restriction, extremely low birth weight, inadequate feeding volume, cholestasis, and late-onset sepsis are significant risk factors for MBD in BPD infants.
  • Prolonged diuretic use is also identified as a risk factor.
  • These findings highlight potential predictive factors for MBD in BPD infants, necessitating prospective validation.
Abstract

Keywords:
Bronchopulmonary dysplasiaMetabolic bone diseasePretermRisk factors

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