Assessment of early nutritional intake in preterm infants with bronchopulmonary dysplasia: a cohort study

Milanesi, Brunna Grazziotti; Lima, Paola At; Villela, Letícia Duarte; Martins, Alejandro; Gomes, Saint Clair; Moreira, Maria Elisabeth Lopes; Méio, Maria Dalva Barbosa Baker

doi:10.1007/s00431-020-03912-0

Cited by 30 publications

(22 citation statements)

References 29 publications

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“…BPD and other markers of severity of neonatal respiratory disease such as receipt of postnatal corticosteroids are associated with postnatal growth failure 59,60 . It is likely that poor nutrition increases the risk for BPD and that both increased severity of illness and treatments for evolving lung disease lead to poor growth 60,61 . Therefore, careful attention to growth and nutrition is essential, both before and after BPD is diagnosed 62 .…”

Section: Influence Of Strategies To Prevent or Treat Bpd On Developmental Outcomesmentioning

confidence: 99%

Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia

DeMauro

2021

Pediatric Pulmonology

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Preterm infants with bronchopulmonary dysplasia (BPD), and particularly those who develop the most severe forms of chronic lung disease during the neonatal period, are at high risk for poor developmental outcomes throughout childhood. Infants who require mechanical ventilation at 36 weeks post‐menstrual age have significantly increased odds for cerebral palsy, developmental delay at 2 years, and poor academic achievement and low intelligence quotient in adolescence. Over the past several decades, many therapies and care strategies, including steroids, continuous positive airway pressure, surfactant, and other medications have been introduced into clinical practice. These approaches have changed the epidemiology of BPD in very preterm infants. However, BPD remains common and strongly associated with poor development throughout childhood. Only caffeine has been proven to reduce BPD and improve childhood developmental outcomes. In future research, it will be essential to better understand the developmental sequelae of BPD beyond school age and to test interventions to improve developmental trajectories in this population. As new management strategies for BPD are developed, it will be essential to rigorously evaluate both short‐term and long‐term effects before they are introduced into routine neonatal practice.

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Section: Influence Of Strategies To Prevent or Treat Bpd On Developmental Outcomesmentioning

confidence: 99%

Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia

DeMauro

2021

Pediatric Pulmonology

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“…An energy intake in the range of 120–150 kcal/kg/day is needed in BPD infants [ 44 ], although a minimum of 140 kcal/kg/day may be necessary during active periods of the disease [ 57 , 93 ]. Providing such high-energy intake in low volumes of feeds remains a challenge and requires concentrating energy and macronutrients [ 20 , 23 ].…”

Section: Nutritional Approach In the Prevention And Management Of Bpdmentioning

confidence: 99%

“…In a cohort study assessing the nutritional supply in very preterm infants, those who developed BPD received an energy intake and energy/protein ratio below that recommended for growth [ 20 ]. In line with these results, in a retrospective case–control study, it was found that extremely preterm infants with BPD received lower energy and fluid intake during the first month of life, and a lower four-week averaged daily energy intake was an independent predictor for BPD [ 23 ].…”

Section: Nutritional Approach In the Prevention And Management Of Bpdmentioning

confidence: 99%

“…After preterm birth, several problems associated with extreme immaturity result in difficulty in achieving sufficient energy and nutrient intake [ 19 ]. A recent study by Milanesi et al [ 20 ] found that preterm infants who developed BPD, compared with those without BPD, received an energy/protein ratio below what is recommended. A retrospective cohort study reported that, in extremely preterm infants, high fluid intake containing low energy during the first postnatal week is associated with the severity of BPD [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…A recent study by Milanesi et al [ 20 ] found that preterm infants who developed BPD, compared with those without BPD, received an energy/protein ratio below what is recommended. A retrospective cohort study reported that, in extremely preterm infants, high fluid intake containing low energy during the first postnatal week is associated with the severity of BPD [ 20 ]. Along the same lines, other studies have described the association of postnatal deficit in energy and nutrient and postnatal growth restriction with the development of BPD [ 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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The Role of Nutrition in the Prevention and Management of Bronchopulmonary Dysplasia: A Literature Review and Clinical Approach

Rocha

Guimarães

Pereira‐da‐Silva

2021

IJERPH

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Bronchopulmonary dysplasia (BPD) remains the most common severe complication of preterm birth, and nutrition plays a crucial role in lung growth and repair. A practical nutritional approach for infants at risk of BPD or with established BPD is provided based on a comprehensive literature review. Ideally, infants with BPD should receive a fluid intake of not more than 135‒150 mL/kg/day and an energy intake of 120‒150 kcal/kg/day. Providing high energy in low volume remains a challenge and is the main cause of growth restriction in these infants. They need a nutritional strategy that encompasses early aggressive parenteral nutrition and the initiation of concentrated feedings of energy and nutrients. The order of priority is fortified mother’s own milk, followed by fortified donor milk and preterm enriched formulas. Functional nutrient supplements with a potential protective role against BPD are revisited, despite the limited evidence of their efficacy. Specialized nutritional strategies may be necessary to overcome difficulties common in BPD infants, such as gastroesophageal reflux and poorly coordinated feeding. Planning nutrition support after discharge requires a multidisciplinary approach to deal with multiple potential problems. Regular monitoring based on anthropometry and biochemical markers is needed to guide the nutritional intervention.

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Association between neonatal malnutrition and bronchopulmonary dysplasia in very low‐birth‐weight infants: A propensity score–matched analysis

Jiang

Hou

et al. 2022

Nut in Clin Prac

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To investigate the relationship between the nutrition status of infants with bronchopulmonary dysplasia (BPD) at the first 4 weeks of life and the likelihood of developing neonatal malnutrition. Methods:A total of 1064 infants were divided into a BPD group and a non-BPD group. After propensity score matching, there were 282 infants in each group. Infants were further divided into a neonatal malnutrition (NM) group and a wellnourished (WN) group. Clinical factors, nutrition intake, and growth parameters were collected and analyzed. Multivariate logistic regression model was used to determine the factors associated with neonatal malnutrition.Results: 1. Compared with infants in the non-BPD group, the infants in BPD group had more fluid intake and lower calorie and protein intake after the second week, longer invasive ventilation time, and longer time to total oral feeding and parenteral nutrition (PN), and the difference was more significant in NM infants than in WN infants (P < 0.05). 2. The weight/length, body mass index, triponderal mass index, and weight gain velocity in the BPD group were significantly lower than in the non-BPD group (P < 0.05) and lower in NM infants than in WN ones (P < 0.05). 3. Multivariable system regression analysis showed that invasive ventilation time, lipid intake in week 4, time to reach full feeding, and duration of PN were independent risk factors for NM. Conclusion:Enhancing calorie and macronutrient intake, reducing invasive ventilation, and achieving full gastrointestinal feeding early may be effective measures to avoid malnutrition in infants with BPD.

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Assessment of early nutritional intake in preterm infants with bronchopulmonary dysplasia: a cohort study

Cited by 30 publications

References 29 publications

Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia

Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia

The Role of Nutrition in the Prevention and Management of Bronchopulmonary Dysplasia: A Literature Review and Clinical Approach

Association between neonatal malnutrition and bronchopulmonary dysplasia in very low‐birth‐weight infants: A propensity score–matched analysis

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