Nutrition and fluid management at 1 week postnatally and the risk of bronchopulmonary dysplasia in preterm infants: A Meta-Analysis

Abstract

OBJECTIVE To explore the intricate interplay between nutritional status, fluid management in the early postnatal phase of preterm infants, and the susceptibility to bronchopulmonary dysplasia (BPD). METHODS A meticulous review encompassing PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, China Knowledge Network, Wanfang Database, and Wipu Database was conducted. The search spanned up to October 7, 2023, focusing on case-control and cohort studies delving into the nexus of nutritional management and BPD. Meta-analysis, employing RevMan 5.3 and Stata 15.0 software, was carried out to synthesize the findings. RESULTS Incorporating 10 studies with a total of 1325 subjects (644 with BPD and 681 normal control), our meta-analysis revealed a significant reduction in calorie intake during the 1st week postnatally in the BPD group compared to the non-BPD group (MD = -5.94, 95% CI: -7.38 to -4.51, P < 0.05). Although fluid loading in both groups exhibited no statistical significance (MD = 5.83, 95% CI: -1.37-13.03, P = 0.11 > 0.05), macronutrient disparities were evident in the BPD group. Protein (MD = -0.13, 95% CI: -0.22 to -0.04, P < 0.05), lipids (MD = -0.39, 95% CI: -0.49 to -0.299,, P < 0.05), and carbohydrates (MD = -0.74, 95% CI: -0.95 to -0.54, P < 0.05) in the BPD group exhibited significantly lower intake during the initial postnatal week. Moreover, the BPD group experienced a prolonged time to achieve complete enteral nutrition compared to the non-BPD group (MD = 9.71, 95% CI: 7.78–11.63, P < 0.05). CONCLUSION Insufficient early nutritional intake may correlate with heightened BPD risk. Vigilant attention to nutritional and fluid management, coupled with optimization of respiratory support protocols, is imperative to mitigate BPD incidence.