Association between Birth Weight and Bronchopulmonary Dysplasia in <32 Weeks of Singleton Infants

Kee Hyun Cho; Jaewoo An; Heui Seung Jo; Kyu Hyung Lee

doi:10.14734/PN.2017.28.2.35

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Cho, An, Jo, and Lee: Association between Birth Weight and Bronchopulmonary Dysplasia in <32 Weeks of Singleton Infants

Original Article

Perinatology 2017;28(2):35-40.

Published online: 19 June 2017

DOI: https://doi.org/10.14734/PN.2017.28.2.35

Association between Birth Weight and Bronchopulmonary Dysplasia in <32 Weeks of Singleton Infants

Kee Hyun Cho, MD, Jaewoo An, MD, Heui Seung Jo, MD, Kyu Hyung Lee, MD

Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea

Correspondence to Heui Seung Jo, MD Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea Tel: +82-31-780-5230 Fax: +82-31-780-3900 E-mail: joneona@cha.ac.kr

Received 6 February 201722 April 2017 Accepted 18 May 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Intrauterine growth retardation of lung has been suggested as being one of the risk factors in the development of bronchopulmonary dysplasia (BPD). The aim of this study was to clarify birth weight percentile among Korean infants using the contemporary Korean reference curve for birth weight by gestational age published in 2014, and on the basis of that clarification, identify the association between birth weight percentile and BPD development.

Methods

All newborn infants born at <32 weeks of gestation admitted to the neonatal intensive care unit of CHA Bundang Medical Center from January 2010 through December 2015 were reviewed. Infants were divided into BPD group and non-BPD group. BPD was defined as a need of oxygen or positive airway pressure at 36 weeks postmenstrual age. All prenatal and neonatal data were collected via retrospective chart review and analyzed by multivariate logistic regression analysis.

Results

During the study period, 198 singleton infants were born at <32 weeks’ gestation. Among these, 179 infants were included, 54 infants in BPD group and 125 infants in non-BPD group. According to logistic regression analysis, lower gestational age, lower birth weight percentile, occurrence of late onset sepsis showed increased risk of BPD (odds ratio [OR] 0.77, P=0.027; OR 0.98, P=0.021; OR 7.98, P<0.0001).

Conclusion

In this single center study, lower birth weight percentile in preterm infants seems to increase the risk of BPD. In these infants, anticipate the high risk of BPD and cautious treatment strategies are needed.

Keywords: Intrauterine growth retardation, Bronchopulmonary dysplasia, Preterm birth

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Table 1.

Perinatal Variables in Bronchopulmonary Dysplasia (BPD) Infants and Non-BPD Infants

Variables	BPD (n=54)	Non-BPD (n=125)	P-value
Gestational age (wks)	28⁺⁶ [26⁺²–30⁺⁴]	30⁺³ [29⁺⁰–31⁺²]	<0.001
Birth weight (g)	1,050 [860–1,400]	1,490 [1,200–1,680]	<0.001
Birth weight percentile	45 [20–65]	60 [35–80]	0.007
Male	26 (48.1)	64 (51.2)	0.708
Maternal age (yrs)	33.3 [31–37]	32.7 [30–35]	0.583
IVF	10 (18.5)	8 (6.4)	0.013
Prenatal corticosteroids	25 (46.3)	58 (46.4)	0.990
GDM	7 (13.0)	12 (9.6)	0.503
PIH	11 (20.4)	21 (16.8)	0.567
PROM ≥18 h	15 (27.8)	37 (29.6)	0.805
Chorioamnionitis	19 (35.2)	37 (29.8)	0.480
Cesarean section	40 (74.1)	60 (48.0)	0.001
Apgar at 5 min <7	28 (51.9)	42 (33.6)	0.022
Intubation at delivery room	41 (77.4)	63 (50.4)	0.001

Values are expressed as number (%) or median with the 25th and 75th percentiles in square brackets. Abbreviations: IVF, in vitro fertilization; GDM, gestational diabetes mellitus; PIH, pregnancy-induced hypertension; PROM, premature rupture of membrane.

Table 2.

Neonatal Morbidity in Bronchopulmonary Dysplasia (BPD) Infants and Non-BPD Infants

	BPD (n=54)	Non-BPD (n=125)	P-value
RDS	47 (87.0)	101 (80.8)	0.311
Number of surfactant treatment	1.54±0.61	1.21±0.60	0.001
PDA ligation	7 (13.0)	3 (2.4)	0.009
Severe IVH	3 (5.6)	0 (0)	0.026
NEC	2 (3.7)	0 (0)	0.090
ROP	5 (9.4)	3 (2.4)	0.053
Cystic PVL	3 (5.6)	1 (0.8)	0.083
Late onset sepsis	21 (39.6)	8 (6.4)	<0.001
Duration of invasive MV (days)	53 [27-80]	3 [2-6]	<0.001
Duration of noninvasive MV (days)	4 [0-8]	0 [0-3]	0.006
Duration of oxygen supply (days)	80.5 [52-95]	14 [9-30.0]	<0.001
Duration of hospitalization (days)	97 [71-111]	47 [37-62]	<0.001

Values are expressed as number (%) or mean±SD or median with the 25th and 75th percentiles in square brackets. Abbreviations: RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; IVH, intraventricular hemorrhage; NEC, necrotizing enterocolitis; ROP, retinopathy of prematurity; PVL, periventricular leukomalacia; MV, mechanical ventilation.

Table 3.

Multivariate Logistic Regression Analysis for Bronchopulmonary Dysplasia (n=179)

Risk factor	Odds ratio	95% Confidence interval	P-value
Gestational age	0.77	0.61–0.97	0.027
Birth weight percentile	0.98	0.97–0.99	0.021
Cesarean section	2.45	0.98–6.11	0.055
Intubation at delivery room	1.68	0.62–4.55	0.309
Number of surfactant treatment	1.57	0.81–3.07	0.186
PDA ligation	6.18	0.99–38.67	0.051
Late onset sepsis	7.98	2.91–21.86	<0.001

Abbreviation: PDA, patent ductus arteriosus.

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