Girija Natarajan1, Yvette R Johnson2, Beverly Brozanski3, Kathryn N Farrow4, Isabella Zaniletti5, Michael A Padula6, Jeanette M Asselin7, David J Durand7, Billie L Short8, Eugenia K Pallotto9, Francine D Dykes10, Kristina M Reber11, Jacquelyn R Evans6, Karna Murthy4. 1. Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, Michigan. 2. Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. 3. Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 5. Childrens' Hospital Association, Overland Park, Kansas. 6. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 7. Children's Hospital Oakland and Research Center, Oakland, California. 8. Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia. 9. Department of Pediatrics, University of Missouri School of Medicine, Kansas City, Missouri. 10. Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia. 11. Department of Pediatrics and Center for Perinatal Research, Division of Neonatology; Columbus, Ohio.
Abstract
OBJECTIVES: To characterize postnatal growth failure (PGF), defined as weight < 10th percentile for postmenstrual age (PMA) in preterm (≤ 27 weeks' gestation) infants with severe bronchopulmonary dysplasia (sBPD) at specified time points during hospitalization, and to compare these in subgroups of infants who died/underwent tracheostomy and others. STUDY DESIGN: Retrospective review of data from the multicenter Children's Hospital Neonatal Database (CHND). RESULTS: Our cohort (n = 375) had a mean ± standard deviation gestation of 25 ± 1.2 weeks and birth weight of 744 ± 196 g. At birth, 20% of infants were small for gestational age (SGA); age at referral to the CHND neonatal intensive care unit (NICU) was 46 ± 50 days. PGF rates at admission and at 36, 40, 44, and 48 weeks' PMA were 33, 53, 67, 66, and 79% of infants, respectively. Tube feedings were administered to > 70% and parenteral nutrition to a third of infants between 36 and 44 weeks' PMA. At discharge, 34% of infants required tube feedings and 50% had PGF. A significantly greater (38 versus 17%) proportion of infants who died/underwent tracheostomy (n = 69) were SGA, compared with those who did not (n = 306; p < 0.01). CONCLUSIONS: Infants with sBPD commonly had progressive PGF during their NICU hospitalization. Fetal growth restriction may be a marker of adverse outcomes in this population. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVES: To characterize postnatal growth failure (PGF), defined as weight < 10th percentile for postmenstrual age (PMA) in preterm (≤ 27 weeks' gestation) infants with severe bronchopulmonary dysplasia (sBPD) at specified time points during hospitalization, and to compare these in subgroups of infants who died/underwent tracheostomy and others. STUDY DESIGN: Retrospective review of data from the multicenter Children's Hospital Neonatal Database (CHND). RESULTS: Our cohort (n = 375) had a mean ± standard deviation gestation of 25 ± 1.2 weeks and birth weight of 744 ± 196 g. At birth, 20% of infants were small for gestational age (SGA); age at referral to the CHND neonatal intensive care unit (NICU) was 46 ± 50 days. PGF rates at admission and at 36, 40, 44, and 48 weeks' PMA were 33, 53, 67, 66, and 79% of infants, respectively. Tube feedings were administered to > 70% and parenteral nutrition to a third of infants between 36 and 44 weeks' PMA. At discharge, 34% of infants required tube feedings and 50% had PGF. A significantly greater (38 versus 17%) proportion of infants who died/underwent tracheostomy (n = 69) were SGA, compared with those who did not (n = 306; p < 0.01). CONCLUSIONS:Infants with sBPD commonly had progressive PGF during their NICU hospitalization. Fetal growth restriction may be a marker of adverse outcomes in this population. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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