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Rehospitalization and growth of infants with bronchopulmonary dysplasia: a matched control study
1Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia.
Insights
Infants with bronchopulmonary dysplasia (BPD) face higher rehospitalization risks, especially for respiratory issues and poor growth. However, home oxygen therapy may help BPD infants achieve similar growth patterns to non-BPD peers.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Developmental Pediatrics
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Infants with BPD often experience developmental challenges and increased healthcare needs.
Purpose of the Study:
- To compare hospitalization risks and growth trajectories in the first year of life for infants with BPD versus matched controls.
- To investigate the impact of home oxygen therapy on growth in BPD infants.
Main Methods:
- A cohort of 78 infants with BPD (26-33 weeks gestation) and 78 birthweight-matched controls were studied.
- Hospitalization history and growth parameters were assessed at 4, 8, and 12 months corrected age.
Main Results:
- BPD infants showed significantly higher rehospitalization rates (58% vs 35%), particularly for respiratory causes and failure to thrive.
- While initial weight faltering was noted in BPD infants, growth differences diminished over the first year.
- BPD infants on home oxygen therapy had higher rates of hospitalization for failure to thrive compared to BPD infants without home oxygen.
Conclusions:
- Infants with BPD are at an elevated risk of rehospitalization during their first year.
- Appropriate home oxygen support may facilitate comparable growth outcomes for BPD infants relative to their non-BPD counterparts.
Objective:
To determine the risk of hospitalization and the growth during the first year of life in infants with bronchopulmonary dysplasia (BPD) and birthweight matched controls.
Methodology:
The study population consists of 78 infants of 26 to 33 weeks gestation with BPD of whom 20 were discharged on home oxygen therapy. The 78 control infants were matched with the study infants for broad based birthweight categories. Infants were reviewed at 4, 8 and 12 months corrected for prematurity at which time the history of rehospitalization was recorded and growth parameters were measured.
Results:
Infants with BPD were found to have a higher overall rate of rehospitalization (58 vs 35%, relative risk (RR) 1.7, 95% confidence interval (Cl) 1.2-2.4) and were more likely to be readmitted for respiratory illnesses (39 vs 20%, RR 1.9, 95% Cl 1.1-3.2) and for poor growth (14 vs 1%, RR 14, 95% Cl 1.7-82) than the control group. Many infants, both study and control, remained below the 10th percentile at 1 year of age. More BPD infants were below the 10th percentile in weight at the 4 month visit than the control infants (30 vs 15%, P = 0.034). This difference was neither present at subsequent visits nor in the other major growth parameters. The 20 BPD infants who were on home oxygen therapy were more frequently hospitalized for concerns with failure to thrive (30 vs 9%, RR 3.3, 95% Cl 1.2-8.9) than the remaining 58 BPD infants. No significant differences were detected in the overall rate of rehospitalization. Poor growth at the corrected age of 1 year was similar in the two subgroups of infants.
Conclusions:
BPD infants are at increased for risk rehospitalization during the first year of life. While many infants with BPD have growth failure, it is suggested that the provision of appropriate supplemental oxygen at home may result in those infants having similar growth patterns when compared to birthweight matched preterm infants without BPD.