TOP 66 - Assessment of Correlation of BPD Severity and Growth Parameters

Publication Number: 4770.TOP 66

Muttaz Abusamra, University of Texas Medical Branch School of Medicine, Galveston, TX, United States; Rania Atieh, University of Texas Medical Branch School of Medicine, Galveston, TX, United States; Tiffany R. Nance, Sodexo at University of Texas Medical Branch, Galveston, TX, United States; Valerie Coindreau, Sodexo at the University of Texas Medical Branch, Galveston, TX, United States; Maria E. Franco-Fuenmayor, University of Texas Medical Branch School of Medicine, Galveston, TX, United States

Background: Nutrition plays a vital role in managing preterm infants, particularly those at risk for bronchopulmonary dysplasia (BPD). The current approach to defining BPD severity was refined by Jensen et al, who categorized disease severity at 36 weeks’ gestation based solely on the level of respiratory support required, independent of prior treatment duration or methods. Evidence indicates that poor postnatal growth is associated with increased BPD severity and worse neurodevelopmental outcomes, whereas optimal growth in the NICU improves these outcomes. Additionally, factors such as parenteral nutrition, protein intake, and early enteral feeding impact growth but lack standardized evaluation protocols. Given the critical role of nutrition in BPD management, growth assessment using modified-hybrid Fenton growth charts may provide novel predictive value for stratifying at-risk infants, an area not yet explored in existing literature.

Objective: This study seeks to assess the prognostic value of growth parameters in preterm infants born between ≥25 and ≤30 weeks of gestation who are at high risk for BPD. By employing the modified hybrid Fenton growth charts and specifically using Z-scores, the research aims to determine whether growth metrics can serve as a reliable predictor for the risk and severity of BPD, and to establish their potential correlation with long-term clinical outcomes. Additionally, the study will investigate how growth trajectories influence the necessity of respiratory support at 36 weeks postmenstrual age and/or at the time of discharge.

Design/Methods: We conducted a retrospective cohort chart review of preterm infants (n=250) born between 25-30 weeks of gestation from 2020-2025, based on the high prevalence of BPD in this population and assessed growth metrics which included measurements of weight, length, and head circumference at specific time points: birth, 2 weeks (when weight is typically regained in 95% of cases), 4 weeks PMA age, 36 weeks PMA age, and at discharge. Demographic variables include gender, race/ethnicity, and weight for gestational age categorization. Additional metrics include BPD severity, modality and days on respiratory support nutritional intake (enteral vs parenteral), time to full feeds and goal calorie intake. To assess the difference in growth and clinical outcomes, statistical analysis will include descriptive statistics, paired t-test and one way ANOVA with the effects size. Lastly logistic regression will be conducted to adjust for cofounding variables and assess for Z score correlation at different time points and BPD severity.