Severity of bronchopulmonary dysplasia and increased risk of feeding desaturation and growth delay in very low birth weight preterm infants

Because of substantial clinical and laboratory evidence of the efficacy of glucocorticoids in the treatment of acute pulmonary surfactant deficiency in preterm newborns, we explored the hypothesis that maternal antenatal glucocorticoid receipt is followed by reduced risk of bronchopulmonary dysplasia (BPD). A sample of 223 intubated infants weighing less than 1751 g birth weight provided 76 infants with BPD (defined by both oxygen requirement and compatible chest radiograph) and 147 who had neither BPD characteristic by day 28 of life. When compared to babies who received a complete and timely course of antenatal glucocorticoids, those whose mothers received no glucocorticoids were at prominently increased risk of BPD (odds ratio = 3.0; 95% confidence interval = 1.1, 8.2). Babies whose mothers received a partial course of glucocorticoids were not at increased risk of BPD (odds ratio = 1.3; 95% confidence interval = 0.4, 4.3). Stratification by gender and birth weight at 1 kg showed a benefit of therapy in all strata except that of extremely low birth weight male infants. These data support the hypothesis that maternal antenatal glucocorticoid therapy offers very low birth weight infants protection against BPD.

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Relationship Between Spontaneous Kicking and Age of Walking Attainment in Preterm Infants With Very Low Birth Weight and Full-Term Infants

Physical Therapy ◽

10.1093/ptj/84.2.159 ◽

2004 ◽

Vol 84 (2) ◽

pp. 159-172 ◽

Cited By ~ 24

Author(s):

Suh-Fang Jeng ◽

Li-Chiou Chen ◽

Kuo-Inn Tsou ◽

Wei J Chen ◽

Hong-Ji Luo

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Proportional Hazards ◽

Very Low Birth Weight ◽

Cox Proportional Hazards ◽

Full Term ◽

Walking Ability ◽

Term Infants ◽

Increased Risk

Abstract Background and Purposes. Although early kicking differences have been reported for preterm infants without overt cranial sonographic abnormalities, their functional importance remains unclear because no outcomes have been measured. Therefore, the first purpose of this prospective study was to examine the age of walking attainment in preterm infants who had very low birth weight (VLBW) but no overt neurosonographic abnormalities and full-term infants without known impairments or pathology. The second purpose was to examine the relationship between spontaneous kicking and age of walking attainment in these infants. Subjects and Methods. Twenty-two preterm infants and 22 full-term infants were examined for kicking movements at 2 and 4 months corrected age and were followed up for age of walking attainment until 18 months corrected age. Results. Survival analysis showed that infants with VLBW attained walking ability at older ages than full-term infants after correction for prematurity. Cox proportional-hazards regression analyses for all infants revealed that a high hip-knee correlation at 2 months corrected age, a high kick frequency at 4 months corrected age, and a short intra-kick pause together with a low variability in interlimb coordination at 2 and 4 months corrected age were all associated with a decreased rate of walking attainment. Discussion and Conclusion. The results indicated that preterm infants who had VLBW but no overt neurosonographic abnormalities had an increased risk of delayed walking attainment compared with full-term infants. Alterations of spontaneous kicking may predict a decreased rate of walking attainment in both preterm and full-term infants.

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Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants

BMC Pediatrics ◽

10.1186/s12887-020-02394-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yan Xu ◽

Zhangbin Yu ◽

Qianqian Li ◽

Jinjun Zhou ◽

Xiaoguang Yin ◽

...

Keyword(s):

Quality Improvement ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Very Low Birth Weight ◽

Research Database ◽

Vlbw Infants ◽

Dose Dependent

Abstract Background and aim Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1–24 mL/(kg · day), 25–49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1–24 ml/(kg · day), 139 (14.4%) received 25–49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration ClinicalTrials.gov Identifier: NCT03453502. Registration date: March 5, 2018. This study was retrospectively registered.

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Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth weight preterm infants

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd002057.pub4 ◽

2017 ◽

Cited By ~ 6

Author(s):

Sachin S Shah ◽

Arne Ohlsson ◽

Henry L Halliday ◽

Vibhuti S Shah

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Very Low Birth Weight ◽

Systemic Corticosteroids

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The Angiotensin Converting Enzyme Insertion/Deletion polymorphism is not associated with an increased risk of death or bronchopulmonary dysplasia in ventilated very low birth weight infants

BMC Pediatrics ◽

10.1186/1471-2431-4-26 ◽

2004 ◽

Vol 4 (1) ◽

Cited By ~ 23

Author(s):

Krishna Yanamandra ◽

John Loggins ◽

R John Baier

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Angiotensin Converting Enzyme ◽

Bronchopulmonary Dysplasia ◽

Very Low Birth Weight ◽

Converting Enzyme ◽

Deletion Polymorphism ◽

Low Birth Weight Infants ◽

Risk Of Death ◽

Increased Risk

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Neurodevelopmental assessment of very low birth weight preterm infants at corrected age of 18-24 months by Bayley III scales

Jornal de Pediatria ◽

10.2223/jped.2230 ◽

2012 ◽

Cited By ~ 3

Author(s):

Luciana Volpiano Fernandes ◽

Ana Lucia Goulart ◽

Amélia Miyashiro Nunes dos Santos ◽

Marina Carvalho de Moraes Barros ◽

Camila Campos Guerra ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Very Low Birth Weight

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Early hyperglycaemia was linked to a risk of late‐onset sepsis in very low birth weight preterm infants in a neonatal intensive care unit

Acta Paediatrica ◽

10.1111/apa.16007 ◽

2021 ◽

Author(s):

Paolo Manzoni ◽

Alessandro Messina ◽

Simone Ceratto ◽

Eleonora Tognato ◽

Mauro Stronati ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care Unit ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Late Onset ◽

Late Onset Sepsis

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Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03510-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiajia Jing ◽

Yiheng Dai ◽

Yanqi Li ◽

Ping Zhou ◽

Xiaodong Li ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Very Low Birth Weight ◽

Postnatal Growth ◽

Weight Increase ◽

Antenatal Corticosteroids ◽

Lung Maturation ◽

Growth Outcomes

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.

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