Risk Factors of Metabolic Bone Disease in Bronchopulmonary Dysplasia Premature Infants With Gestational Age Less Than 32 Weeks

Abstract BackgroundMetabolic bone disease (MBD) is a complication of multifactorial aetiology in preterm infants. Several risk factors have been identified in general. Bronchopulmonary Dysplasia (BPD) infants present an increased incidence of MBD, but it is unknown which factors contribute to this. The aim of this study was to determine the risk factors for developing MBD in BPD infants.MethodsA retrospective review of the medical records of BPD infants admitted to the Neonatal Intensive Care Unit (NICU) at Zhangzhou Hospital between Jun 2016 and May 2020. BPD infants with MBD were identified, two contemporaneous without MBD matched by gestational age and gender were randomly selected as control infants for each case of MBD. The association between putative risk factors and MBD was estimated with ORs and 95% CIs. A P-value threshold ≤0.2 was used in univariate analysis for inclusion into a multivariate (adjusted) model with a P-value of < 0.05 as statistically significant.ResultsA total of 156 BPD infants were enrolled with 52 cases of MBD and 104 controls. Fetal growth restriction (OR 5.60, 95% CI, 1.77–17.72), extremely low birth weight (OR 3.70, 95% CI, 1.35–10.10), feeding volume ＜80 mL/kg/day at the end of the 4th week after birth (OR 12.21, 95% CI, 3.89–38.33), cholestasis (OR 4.29, 95% CI, 1.65–11.15), and late onset sepsis (OR 3.79, 95% CI, 1.12–12.77) were found to be statistically significant risk factors for MBD in BPD infants.ConclusionIn gestational age homogeneous BPD infants, fetal growth restriction, extremely low birth weight, feeding volume＜80 mL/kg/day at the end of the 4th week after birth and late onset sepsis are significant risk factors for MBD. These findings provide potential predictive factors for MBD in BPD infants but still warrant prospective validation.