Dianova Ekaterina, Higano Nara S, McNelis Kera M, Ehrlich Shelley R, Liu Chunyan, Woods Jason C, Kingma Paul S
Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Neonatology. 2025;122(3):319-328. doi: 10.1159/000543605. Epub 2025 Jan 22.
Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates.
In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed.
The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p < 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p < 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04).
Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI.
胎儿和新生儿生长受限是早产儿发生支气管肺发育不良（BPD）的已知危险因素。然而，营养和婴儿生长对BPD患儿肺生长的具体影响尚不清楚。此外，BPD中所有的肺生长是否都有益也不明确。我们假设BPD的肺生长发育及严重程度与早产儿的热量和蛋白质摄入、体重增加及线性生长直接相关。
在这项回顾性研究中，分析了出生后前4周的热量和蛋白质摄入量、生长参数以及通过超短回波时间（UTE）MRI获得的肺容积、质量、密度和BPD严重程度。
该队列包括95例平均胎龄26.1周、出生体重790 g的新生儿。与1级BPD患儿相比，2级和3级BPD患儿在出生后前4周的热量和蛋白质摄入量较低（分别为96/98 vs. 106 kcal/kg/天；3.79/3.75 vs. 3.99 g蛋白质/kg/天；p<0.05）。UTE MRI显示，每体表面积的肺质量随BPD严重程度增加而增加（1级、2级和3级分别为237、311、384 g/m²，p<0.05）。热量摄入增加与肺质量降低（p = 0.02）和MRI上BPD评分改善（p = 0.04）相关。
出生后前4周营养摄入减少似乎与更严重的BPD、肺质量增加以及MRI上更严重的肺部疾病有关。
