B60-32 Anthropometric Monitoring in Preterm Infants With Bronchopulmonary Dysplasia

Rationale

Bronchopulmonary dysplasia (BPD) is a chronic lung disease of prematurity associated with increased metabolic demand and impaired postnatal growth.1 Suboptimal somatic growth from infancy into early childhood in patients with BPD has been associated with increased respiratory morbidity.2 While close outpatient growth monitoring is recommended following neonatal intensive care unit (NICU) discharge3, the relationship between early post-discharge anthropometric trends and respiratory recovery remains incompletely defined.

Methods

We conducted a retrospective cohort study of infants born <32 weeks gestation with BPD (using the 2019 Jensen criteria4 for BPD diagnosis) who were discharged from a tertiary NICU on supplemental oxygen and followed in outpatient pulmonary and special infant clinics for six months post-discharge. Infants with cyanotic congenital heart disease, severe neurologic impairment, ventilator dependence, or neuromuscular disease were excluded. Anthropometric data (weight, length, and weight-for-length) obtained at discharge and approximately six months post-discharge were converted to World Health Organization z-scores using chronological age. Growth failure was defined as a decline in weight-for-age z-score ≥ 0.8. The primary outcome was successful weaning from supplemental oxygen by six months post-discharge. Associations between growth, visit frequency, and oxygen weaning were examined using multivariate analyses.

Results

72 infants met inclusion criteria; 53 (74%) successfully weaned from supplemental oxygen by six months, while 19 (26%) remained oxygen dependent. Infants who remained oxygen-dependent had significantly lower weight-for-length z-scores at six months post-discharge compared with those who successfully weaned (-0.89 vs 0.02). Changes in weight-for-age z-score (+2.07 vs + 1.48) and length-for-age z-score (+2.45 vs + 2.54) were similar between groups. The frequency of outpatient visits did not differ between groups, including pulmonary clinic (2.6 vs 2.7), special infant care clinic (1.6 vs 1.4), or registered dietitian appointments (2.7 vs 2.5). Rates and timing of growth failure did not differ between the two groups of infants.

Conclusions

Among preterm infants with BPD discharged on supplemental oxygen, improvement in weight-for-length over the first six months post-discharge was associated with successful oxygen weaning, whereas absolute weight and linear growth were not. Visit frequency alone did not predict growth or respiratory outcomes, potentially reflecting confounding by medical complexity. Monitoring early post-discharge changes in weight-for-length may help identify infants with BPD at risk for delayed oxygen weaning and inform outpatient nutritional management strategies.

This abstract is funded by: None