Abstract
Background and objectivesSmall for gestational age and preeclampsia have both been described as risk factors for bronchopulmonary dysplasia in preterm neonates, but their respective role in the occurrence of bronchopulmonary dysplasia is debated. We evaluated the relation between small for gestational age and bronchopulmonary dysplasia in neonates born to mothers with preeclampsia. We hypothesized that low birth weight is still associated with bronchopulmonary dysplasia in this homogeneous population.MethodsRetrospective single-center cohort study including 141 neonates born between 24 and 30 weeks’ gestation to mothers with preeclampsia. The main outcome measure was moderate to severe bronchopulmonary dysplasia at 36 weeks’ postmenstrual age. Neonates born small for gestational age (birthweight < 10th percentile on the AUDIPOG curves) were compared to those with appropriate birthweight for gestational age by bivariable analyses and logistic regression models, estimating odds ratios (ORs) and 95% confidence intervals (CIs).ResultsBronchopulmonary dysplasia rates were 61.5% (32/52) and 27.4% (20/73) for small for gestational age and appropriate birthweight for gestational age neonates (p < .001). On adjustment for gestational age and other confounding factors, the risk of moderate to severe bronchopulmonary dysplasia was greater for small for gestational age than appropriate birthweight for gestational age neonates (adjusted OR = 5.9, 95% CI [2.2–15.4]), as was the composite outcome death or moderate to severe bronchopulmonary dysplasia (adjusted OR = 4.7, 95% CI [1.9–11.3]).ConclusionsSmall for gestational age was associated with bronchopulmonary dysplasia in very preterm neonates born to mothers with preeclampsia.Registration numberCNIL no. 1747084.
Highlights
Bronchopulmonary dysplasia (BPD) is the main respiratory sequelae of preterm birth; it is characterized by arrested alveolar development with reduced number but increased size of alveoli and impaired capillaries [1]
We evaluated the relation between small for gestational age and bronchopulmonary dysplasia in neonates born to mothers with preeclampsia
Small for gestational age was associated with bronchopulmonary dysplasia in very preterm neonates born to mothers with preeclampsia
Summary
Bronchopulmonary dysplasia (BPD) is the main respiratory sequelae of preterm birth; it is characterized by arrested alveolar development with reduced number but increased size of alveoli and impaired capillaries [1]. Several studies found the risk of BPD two- to six-fold higher for SGA preterm infants than AGA newborns [2,4,5]. Preeclampsia as a risk factor for BPD has several hypotheses This pregnancy disease often leads to SGA and premature birth, because delivery is the only treatment. Previous studies of BPD incidence in SGA preterm infants did not account for the causes of growth restriction [12,13]. As a result, they mostly compared SGA infants born to mothers with vascular diseases of pregnancy and AGA infants born to normotensive mothers. The BPD–SGA relation may be explained wholly or in part by the presence of preeclampsia
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