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Nutritional support during the first week for infants with bronchopulmonary dysplasia and respiratory distress: a

Huijia Lin1, Guannan Bai2, Jiajing Ge1

  • 1Department of NICU, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

BMC Pediatrics
|April 3, 2024
PubMed

Insights

Delayed full enteral nutrition increases bronchopulmonary dysplasia risk in preterm infants. Early nutrition and breastfeeding are protective. Promoting these interventions is crucial for better infant outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Nutritional Science

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication impacting preterm infant survival and long-term health.
  • Early nutritional support is critical for very preterm infants (gestational age < 32 weeks).
  • Identifying nutritional risk factors for BPD is essential for improving clinical outcomes.

Purpose of the Study:

  • To evaluate the impact of early nutritional support in the first week of life on BPD development in very preterm infants.
  • To identify specific nutritional risk factors associated with BPD in this vulnerable population.

Main Methods:

  • A prospective, multicenter cohort study involving 1286 very preterm infants (< 32 weeks gestational age) across 40 NICUs in China.
  • Data on antenatal and postnatal nutritional parameters were collected.
  • Statistical analyses, including multivariate logistic regression, were used to identify BPD risk factors.

Main Results:

  • Factors associated with increased BPD risk included lower birth weight, longer time to full enteral nutrition, higher parenteral protein intake (> 3.5 g/kg/d), formula or mixed feeding (vs. breast milk), persistent ductus arteriosus (hsPDA), and extrauterine growth restriction (EUGR).
  • A longer duration to achieve full enteral nutrition was significantly associated with BPD development (OR 1.03, p < 0.001).
  • Breast milk feeding showed a protective effect against BPD.

Conclusions:

  • Delayed achievement of full enteral nutrition is a significant risk factor for BPD in very preterm infants.
  • Breastfeeding demonstrates a protective effect, highlighting its importance in BPD prevention.
  • Promoting early and rapid enteral nutrition, alongside breastfeeding, is recommended for very preterm infants to reduce BPD incidence.
Abstract

Keywords:
BreastmilkBronchopulmonary dysplasiaNutritionPreterm infant

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