Related Factors Between Bronchopulmonary Dysplasia And High-energy Milk Feeding In Premature Infants

Objectives:To analyze the etiology of bronchopulmonary dysplasia(BPD) in premature infants,andthe relationship between all factors and its severity of BPD.To explore the effect ofhigh-energy milk feeding on BPD premature growth and lung function.Which provide theclinical basis to the early diagnosis,prevention and reasonable treatment for BPD.Methods:We collected255cases of premature infants with BPD retrospectively from FirstHospital of Jilin University from Sept.2012to Mar.2015.According to the new definition ofBPD in2000,BPD was divided into mild,moderate and severe.We compared the relationshipbetween clinical factors and BPD dividing.Based on the statistical datum,we selected48casesof premature infants who were fed with101kcal/100ml premature infant formula and56cases fed with81kcal/100ml premature infant formula in the same period.We compared theliquid intake,energy intake and weight-gain of the two groups when they were fed1,2weeksall through the mouth.Results:1. For nearly three years,4331premature infants were treated,255patients werediagnosed with BPD.The incidence of BPD was5.9%. The incidence of BPD in gestationalage(GA)≤28w,28w~,30w~,32w~and34w~were respectively20.3%,13.1%,5.3%,0.95%and0.21%.The incidence of BPD in birth weight(BW)≤750g,750g~,1000g~,1250g~,1500g~wererespectively46.5%,40.6%,20.6%,7.4%,1.3%.The incidence of BPD decreased with theincreasing of GA and BW.2.255cases were treated with mechanical ventilation(100%),143cases inhaled oxygenconcentration>30%(56.1%),143cases were diagnosed with RDS (56.1%),171cases wereinfected(67.1%),228cases were anemia (89.4%),159cases were combined with apnea(62.4%),48cases were diagnosed with PDA (58.0%),228cases were transfused with blood(89.4%), the ratios of the above factors in infants with BPD were high.3. Among255BPD cases,103mild cases (2.48％),59moderate cases(1.47％),84severecases(1.94%).9cases were excluded for giving up,death or transfer hospital.246cases wereincluded;103patients(41.9％) had mild BPD while143patients (58.1％) had moderate/severeBPD. There were statistical differences in RDS,inhaled oxygen concentration> 30%,anemia,transfusion and diuretic between the two groups(P <0.05).Multivariate logisticregression model showed RDS was the high-risk factor for moderate/severe BPD(P=0.016，OR=5.809).4. The differences were statistically significant in weight growth rate, calorie intakebetween the group of101kcal/100ml and the group of81kcal/100ml (P <0.05).Both had nodifferences in fluid intake and the occurrence of NEC (P>0.05).Conclusions:The incidence of BPD had negatively correlated with GA and BW.Mechanicalventilation, inhaled oxygen concentration>30%, RDS, infection, anemia, apnea, PDA andblood transfusion were high risk factors of BPD.RDS, inhaled oxygen concentration>30%,anemia and blood transfusion were closely related to the severity of BPD.RDS wasindependent risk factor.High-energy formula-fed improved the function of pulmonary intheir stable phase while liquid was limited with BPD,shorten the time of aerobicrelatively,promote the growth and development,and did not increase the gastrointestinalcomplications.