Lack of association between early fluid intake and risk of bronchopulmonary dysplasia in extremely low birth weight infants

Abstract

Objective To evaluate the association between fluid intake during the first 14 days of life and the risk of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. Methods A retrospective analysis of a cohort of ELBW admitted in our NICU from 2001 to 2006 compared demographic, clinical data and the daily nutritional intake during the first 14 days of life between the infants with BPD (oxygen at 36 wks pma) and those without BPD. Results Among the 124 infants studied, 22 (17.7%) developed BPD. The mean total fluid intake at 7 days (119±5.3 vs 118.2±8.2 ml/kg/d), at 14 days (136.5±9.1 vs 137.1±8.4 ml/kg/d) and the maximum weight loss (9.0±6.1% vs 10.3±5.2%) were similar in the two groups; BPD infants received higher mean intravenous fluid intake at 14 days (122.9±16.1 vs 109.1±21.8 ml/kg/d). The adjusted risk of higher intravenous fluid intake related to BPD was lost after a multivariate logistic regression analysis that showed GA (OR 0.40; 95% CI 0.30 to 0.52), BW z score (OR 0.47; 95% CI 0.32 to 0.69) and intravenous protein intake at 14 days (OR 0.38; 95% CI 0.18 to 0.80) as the best early independent predictors of BPD. Conclusion In this cohort of ELBW infants early fluid intake was not associated with an increased risk of BPD.