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Bronchopulmonary dysplasia and postnatal growth following extremely preterm birth
  1. Theodore Dassios1,2,
  2. Emma E Williams2,
  3. Ann Hickey3,
  4. Catey Bunce4,
  5. Anne Greenough2,5
  1. 1 Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
  2. 2 Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
  3. 3 Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
  4. 4 School of Population Health and Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
  5. 5 Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK
  1. Correspondence to Dr Theodore Dassios, Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, London, UK; theodore.dassios{at}kcl.ac.uk

Abstract

Objectives To report the current incidence of bronchopulmonary dysplasia (BPD) and to compare changes in weight and head circumference between infants who developed BPD and infants who did not.

Design Retrospective, whole-population study.

Setting All neonatal units in England between 2014 and 2018.

Patients All liveborn infants born <28 completed weeks of gestation.

Interventions The change in weight z-score (ΔWz) was calculated by subtracting the birthweight z-score from the weight z-score at 36 weeks postmenstrual age (PMA) and at discharge. The change in head circumference z-score (ΔHz) was calculated by subtracting the birth head circumference z-score from the head circumference z-score at discharge.

Main outcome measure BPD was defined as the need for any respiratory support at 36 weeks PMA.

Results 11 806 infants were included in the analysis. The incidence of BPD was 57.5%, and 18.9% of the infants died before 36 weeks PMA. The median (IQR) ΔWz from birth to 36 weeks PMA was significantly smaller in infants who developed BPD (−0.69 (−1.28 to −0.14), n=6105) than in those who did not develop BPD (−0.89 (−1.40 to −0.33), n=2390; adjusted p<0.001). The median (IQR) ΔHz from birth to discharge was significantly smaller in infants who developed BPD (−0.33 (−1.69 to 0.71)) than in those who did not develop BPD (−0.61 (−1.85 to 0.35); adjusted p<0.001).

Conclusions Postnatal growth was better in infants diagnosed with BPD compared with infants without BPD possibly due to more aggressive nutrition strategies.

  • growth
  • neonatology
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Footnotes

  • Contributors TD conceived the study, wrote the study protocol, participated in the analysis and wrote the first version of the manuscript. EEW acquired the data, contributed to securing regulatory approvals and participated in the analysis of data. AH participated in the design of the study and in writing of the manuscript and critically reviewed the manuscript. CB participated in the design of the study and led in the methodology of data analysis. AG participated in the design of the study and analysis and critically revised the manuscript. All authors approved the final manuscript.

  • Funding The research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St Thomas' NHS Foundation Trust and King’s College London.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The National Neonatal Research Database is approved by the National Research Ethics Service (10/H0803/151), Confidentiality Advisory Group of the Health Research Authority (8-05[f]/2010), and the Caldicott guardians and lead clinicians of the contributing hospitals. As the study used data held in an existing database, participation did not require approval from individual Trusts, but only from the NHS Trust holding the database (Chelsea and Westminster NHS Foundation Trust) which was obtained. This study was approved by the West Midlands - Edgbaston Research Ethics Committee (REC reference: 19/WM/0172) and the UK Health Research Authority (HRA) (IRAS project ID: 259225).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data will be made be available on request from the corresponding author.

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