Early energy restriction in premature infants and bronchopulmonary dysplasia: a cohort study

Bronchopulmonary dysplasia (BPD) is a multifactor pathology. Animal studies and cohort studies suggest that poor nutrient intake after birth increases the risk of BPD. The objective of the present study was to determine the existence of association between BPD in very low birth weight (VLBW) and energy intake during the first week of life. We recorded in a retrospective cohort study the intake of enteral and parenteral macronutrients during this period by examining the nutritional and clinical history of 450 VLBW newborns admitted to the neonatal intensive care unit. After applying the relevant exclusion criteria, data for 389 VLBW infants were analysed, of whom 159 developed some degree of BPD. Among the newborns with BPD, energy and lipid intake was significantly lower and fluid intake was significantly higher. The energy intake for the 25th percentile in the group without BPD was 1778 center dot 2 kJ/kg during the first week of life. An energy intake <1778 center dot 2 kJ/kg in this period was associated with a 2-fold increase in the adjusted risk of BPD (OR 2 center dot 63, 95 % CI 1 center dot 30, 5 center dot 34). The early nutrition and the increase of energy intake in the first week of life are associated in our sample with a lower risk of BPD developing.