Higher fluid and lower caloric intakes: associated risk of severe bronchopulmonary dysplasia in ELBW infants

Objective: To examine nutritional intake profiles and growth trajectories of extremely low birth weight (ELBW) infants who develop severe bronchopulmonary dysplasia (BPD). Study design: Case-control study using multiple logistic regression analysis with generalized estimating equations (GEE) to adjust for matching. Results: Cumulative and mean fluid intakes were higher (p = 0.003) and caloric intakes lower (p < 0.0001) through week two in infants who developed severe BPD (n = 120) versus those without severe BPD (n = 104). Mean caloric intake through week 12 was lower in infants who developed severe BPD (102 +/- 10.1 vs. 107 +/- 8.5 kcal/kg/day, p < 0.0001). In the logistic regression models, lower mean caloric intake through week 12 was associated with increased risk of developing severe BPD. Linear growth reduced the odds of BPD by similar to 30% for each Z-score point. Conclusions: Higher fluid and lower total caloric intakes and reductions in linear growth were independently associated with an increased risk of developing severe BPD in ELBW infants.