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Bone mineral content and growth in very-low-birth-weight premature infants. Does bronchopulmonary dysplasia make a
Insights
Very-low-birth-weight infants with bronchopulmonary dysplasia showed similar growth and bone development compared to controls. Other factors, not bronchopulmonary dysplasia, likely cause delayed bone mineralization and growth in these premature infants.
Area of Science:
- Neonatology
- Pediatric Bone Health
- Respiratory Medicine
Background:
- Very-low-birth-weight (VLBW) infants are susceptible to metabolic bone disease and growth retardation, particularly those with bronchopulmonary dysplasia (BPD).
- Understanding the impact of BPD on growth and bone mineral content (BMC) in VLBW infants is crucial for optimizing care.
Purpose of the Study:
- To prospectively compare growth and BMC in VLBW infants with and without BPD during their first year of life.
- To identify factors influencing bone mineralization and growth in this vulnerable population.
Main Methods:
- A prospective study comparing 16 VLBW infants with BPD to 16 matched VLBW control infants.
- Matching was based on gestational age and birth weight.
- Growth parameters (weight, length, head circumference) and BMC were assessed at 1 year of age. Nutrient intakes were monitored during hospitalization.
Main Results:
- No significant differences in BMC, weight, length, or head circumference were observed between VLBW infants with and without BPD at 1 year.
- Both groups exhibited delayed bone mineralization compared to intrauterine standards.
- Growth in both groups lagged behind established growth curves for premature infants.
Conclusions:
- Bronchopulmonary dysplasia did not significantly impact growth or bone mineral content at one year in this VLBW cohort.
- Factors beyond BPD are responsible for the observed delays in bone mineralization and growth in VLBW premature infants.
- Further research is needed to elucidate the specific factors contributing to growth and bone health deficits in VLBW infants.
Abstract:
It is reported that very-low-birth-weight (VLBW) infants with the complication of bronchopulmonary dysplasia (BPD) are at high risk for metabolic bone disease and growth retardation. In a prospective study, we compared growth and bone mineral content (BMC) during the first year of life in 16 VLBW infants with BPD and 16 VLBW control infants. The BPD and control groups were matched for gestational age (28.2 +/- 0.8 vs 28.4 +/- 1.2 weeks) and birth weight (986 +/- 158 vs 1037 +/- 147 g). Calcium, phosphorus, vitamin D, and energy intakes did not differ during the initial 60-day period of hospitalization. At 1 year of age, there were no significant differences in BMC (104.4 +/- 21.4 vs 109.7 +/- 19.2 mg/cm), weight (7440 +/- 1090 vs 7420 +/- 826 g), length (66.9 +/- 3.4 vs 67.7 +/- 3.0 cm), or head circumference (45.1 +/- 1.5 vs 44.0 +/- 1.0 cm) between BPD and control groups. In both groups bone mineralization was delayed compared to the intrauterine curve for BMC. Growth was also delayed compared to the growth curves of Babson for premature infants during the first year of life. We conclude that for our study population, factors other than the presence or absence of BPD are responsible for marked delays in bone mineralization and growth in VLBW premature infants.