Original ArticleAssociation between Fluid Intake and Weight Loss during the First Ten Days of Life and Risk of Bronchopulmonary Dysplasia in Extremely Low Birth Weight Infants
Section snippets
Methods
The Neonatal Research Network recently completed a randomized controlled trial (October,1999-August,2001) to evaluate the efficacy of parenteral glutamine supplementation to reduce the incidence of late onset sepsis in ELBW infants who survived beyond the first 12 hours of life.15 During the course of the trial, the data on daily fluid intake and weight changes of study subjects were collected prospectively. Mortality and incidence of BPD were also documented.
A total of 1433 infants weighing
Results
Of the 1,382 infants in the study cohort, 58% (n = 797) either died (n = 224) or developed BPD (n = 573), while 42% survived without BPD (n = 585). Compared to survivors without BPD, infants who died or developed BPD had significantly lower birth weight and gestational age, more male infants, lower 1 and 5-minute Apgar scores, higher FiO2 requirement at 24 hours of age,longer duration of assisted ventilation, more use of postnatal steroids for BPD and higher incidence of severe IVH, proven NEC,
Discussion
This retrospective analysis of prospectively collected data confirmed our hypothesis that higher fluid intake and lack of postnatal weight loss during the immediate postnatal period predisposed this high-risk group of infants to BPD. Death was included as a primary outcome because it is a competing outcome with BPD. There was a concern that including death as variable may include those infants who died because of physicians' decision to withdraw care due to extreme immaturity and serious
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Cited by (0)
Supported by Grant support: This study is supported by the following grants: HD U10 21397, HD U10 27871, HD U10 27904, HD U10 27851, HD U10 27856, HD U10 36790.