Early nutritional management and risk of neonatal bronchopulmonary dysplasia: a systematic review and mata analysis

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.