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Published on: December 31, 2015
The association between BMI trajectories and bronchopulmonary dysplasia among very preterm infants
Laura Li Ching Ng1,2, Sharina Patel1, Hugues Plourde1
1McGill University, Montreal, QC, Canada.
Insights
An increase in body mass index (BMI) z score from birth to 36 weeks corrected age is linked to higher odds of bronchopulmonary dysplasia (BPD) in preterm infants. This finding suggests tailored growth targets may be needed for infants with evolving lung disease.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Growth and Development
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
- Growth patterns in preterm infants, particularly changes in Body Mass Index (BMI), are crucial for understanding BPD development.
- Disproportionate growth is often observed in preterm infants with evolving lung disease.
Purpose of the Study:
- To investigate the association between the change in Body Mass Index (BMI) z score from birth to 36 weeks gestation (ΔBMI) and the incidence of bronchopulmonary dysplasia (BPD).
- To analyze growth trajectories in preterm infants (<30 weeks gestation) and their correlation with BPD outcomes.
Main Methods:
- A multicenter retrospective cohort study was conducted from 2015-2018.
- Infants born <30 weeks gestation and alive at ≥34 weeks corrected age were included.
- Change in BMI z score from birth to 36 weeks corrected age was analyzed in quartiles using generalized linear mixed models.
Main Results:
- 51% of the 772 included infants developed BPD.
- Infants who developed BPD showed less decrease in weight z score but a greater decrease in length z score compared to BPD-free infants.
- Higher ΔBMI z score quartiles were significantly associated with increased odds of BPD in adjusted analyses.
Conclusions:
- An increase in BMI z score from birth to 36 weeks corrected age is associated with higher odds of BPD in preterm infants.
- These findings suggest that infants with evolving BPD may necessitate distinct growth and nutritional management strategies.
- The study highlights the importance of monitoring BMI changes in high-risk preterm populations.
Objective:
To investigate the association between change in body mass index (BMI) from birth to 36 weeks gestation (ΔBMI) and bronchopulmonary dysplasia (BPD) among infants born <30 weeks gestation.
Methods:
This was a multicenter retrospective cohort study (2015-2018) of infants born <30 weeks gestation and alive at ≥34 weeks corrected. Main exposure was a change in BMI z score from birth to 36 weeks corrected age grouped into quartiles of change. Association between ΔBMI z scores and BPD was assessed using generalized linear mixed models.
Results:
Among 772 included infants, 51% developed BPD. From birth to 36 weeks CGA, the weight z score of infants with BPD decreased less than for BPD-free infants, despite a greater decrease in length z score and similar caloric intake resulting in increases in BMI z score (median [IQR], 0.16 [-0.64; 1.03] vs -0.29 [-1.03; 0.49]; P < 0.01). In the adjusted analysis, higher ΔBMI z score quartiles were associated with higher odds of BPD (Q3 vs Q2, AOR [95% CI], 2.02 [1.23; 3.31] and Q4 vs Q2, AOR [95% CI], 2.00 [1.20; 3.34]).
Conclusion:
Among preterm infants, an increase in BMI z score from birth to 36 weeks corrected is associated with higher odds of BPD.
Impact:
Preterm infants with evolving lung disease often experience disproportionate growth in the neonatal period. In this multicenter cohort study, increases in BMI z score from birth to 36 weeks CGA were associated with higher odds of BPD. Despite similar caloric intake, infants with BPD had a higher weight- but lower length-for-age, resulting in higher BMI z score compared to BPD-free infants. This suggests that infants with evolving BPD may require different growth and nutritional targets compared to BPD-free infants.
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