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Abstract Body

Background: The association between impaired postnatal growth and the diagnosis of bronchopulmonary dysplasia (BPD) has not previously been studied at a population level.

Aims: To report the current incidence of BPD and to compare changes in weight and head circumference in infants who developed BPD compared to the infants who did not develop BPD.

Methods: Retrospective whole-population study of all neonatal units in England. Changes in weight z-score (ΔWz) and head circumference z-score (ΔHz) were calculated by subtracting the birth weight z-score and head circumference z-score from the weight and head circumference z-scores at discharge in all liveborn infants born <28 completed weeks of gestation between 2014-2018. BPD was defined as the need for any respiratory support at 36 weeks post-menstrual age (PMA).

Results: 11,806 infants were included. The incidence of BPD was 57.5%; 18.9% of the infants died before 36 weeks PMA. Both weight and head circumference z-scores decreased over time. The median (IQR) ΔWz was -1.10(-1.78 to -0.47) and median ΔHz was -0.46(-1.73 to 0.50). The median ΔWz was significantly smaller in infants that developed BPD [-1.03(-1.74 to -0.34), n=6,105] compared to the infants that did not develop BPD [-1.34(-1.96 to -0.75), n=2,390; adjusted p<0.001]. The median ΔHz was significantly smaller in infants that developed BPD [-0.33(-1.69 to 0.71)] compared to the infants that did not develop BPD [-0.61(-1.85 to 0.35); adjusted p<0.001].

Conclusions: BPD was a common adverse outcome of extremely preterm birth. Postnatal growth was better in infants diagnosed with BPD compared to infants without BPD.