Yang Jiayi, Mei Hua, Huo Mengyue, Zhang Yuheng, Xin Chun
Department of Neonatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Ital J Pediatr. 2025 Mar 24;51(1):94. doi: 10.1186/s13052-025-01929-5.
This study examines the relationship between early postnatal nutrition, fluid management in preterm infants, and the risk of bronchopulmonary dysplasia (BPD). A comprehensive review was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, and major Chinese databases, covering studies up to 31 August 2024. Case-control and cohort studies on nutritional management and BPD were analyzed using meta-analysis in Stata 15.0. The study is registered on Prospero (CRD42023484951). A total of 11 studies involving 1,826 infants (894 with BPD, 931 controls) were included. Findings showed significantly lower calorie intake in the BPD group during the first postnatal week (Mean Difference = -6.20, 95% CI: -8.91 to -3.48, P < 0.05). While fluid intake differences were not statistically significant (Mean Difference = 5.31, 95% CI: -0.57 to 11.19, P = 0.077), the BPD group had lower protein (Mean Difference = -0.13, 95% CI: -0.22 to -0.04, P < 0.05), lipid (Mean Difference = -0.39, 95% CI: -0.49 to -0.299, P < 0.05), and carbohydrate intake (Mean Difference = -0.74, 95% CI: -0.95 to -0.54, P < 0.05). Time to full enteral nutrition was also prolonged in the BPD group (Mean Difference = 11.23, 95% CI: 9.68-12.78, P < 0.05). These results suggest that inadequate early nutrition may increase BPD risk. Optimizing nutritional and fluid management, alongside respiratory support, is essential for prevention.
本研究探讨了早产婴儿出生后早期营养、液体管理与支气管肺发育不良（BPD）风险之间的关系。对多个数据库进行了全面检索，包括PubMed、Embase、Cochrane图书馆、Web of Science以及主要的中文数据库，检索范围涵盖截至2024年8月31日的研究。使用Stata 15.0软件，通过荟萃分析对营养管理与BPD的病例对照研究和队列研究进行了分析。该研究已在国际前瞻性系统评价注册平台（Prospero，注册号：CRD42023484951）注册。共纳入11项研究，涉及1826名婴儿（894例患有BPD，931例为对照）。研究结果显示，BPD组在出生后第一周的热量摄入量显著较低（平均差异=-6.20，95%置信区间：-8.91至-3.48，P<0.05）。虽然液体摄入量差异无统计学意义（平均差异=5.31，95%置信区间：-0.57至11.19，P=0.077），但BPD组的蛋白质（平均差异=-0.13，95%置信区间：-0.22至-0.04，P<0.05）、脂质（平均差异=-0.39，95%置信区间：-0.49至-0.299，P<0.05）和碳水化合物摄入量（平均差异=-0.74，95%置信区间：-0.95至-0.54，P<0.05）均较低。BPD组达到完全肠内营养的时间也延长了（平均差异=11.23，95%置信区间：9.68-12.78，P<0.05）。这些结果表明，早期营养不足可能会增加BPD风险。优化营养和液体管理以及呼吸支持对于预防BPD至关重要。
