الفهرس 
PREMATURE AND LOW BIRTH WEIGHT INFANTSOnly 14 pages are availabe for public view
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Abstract
B
ronchopulmonary dysplasia continues to be an important problem in premature infants despite improved facilities of care, monitoring and treatment. The etiology of BPD is still unknown but large number of factors are suggested to be involved in the development of the disease and thought to be of multifactorial origin of which oxygen is one factor.
This prospective study presents some possible risk factors for BPD development. The study population consisted of 30 preterm infants admitted to NICU, obstetric & gynecology hospital, Ain Shams University from September 2007 to March 2008 with body weight less than 1500 gm(VLBW) and gestational age equal to or less than 32 weeks.
Body weights were measured daily using electronic scales as part of routine care.
Daily fluid intake and sodium supplementation were prescribed at the discretion of the clinicians and recorded.
The parenteral fluid intake was recorded until the infant reached full enteral feeding. The parenteral fluid intake included intravenous fluid administered as maintenance, total parentral nutrition as well as those given in the form of blood transfusion or fluid used to flush intravascular lines after blood sampling or administration of medications.
Daily enteral feeding volumes were also recorded.
Daily sodium intakes and daily serum electrolytes levels were recorded.
Respiratory data was recorded; mode of assisted ventillation, pressures, mean FiO2, flow rate, duration of assisted ventilation together with oxygen saturation with pulse oximetry. Surfactant use was not noted.
Echocardiography for detection of PDA if suggested.
Transcranial U/S for detection of intracranial hemorrhage if suggested.
Chest X-ray will be done for detection and grading of RDS, and detection, staging of bronchopulmonary dysplasia.
Sepsis was diagnosed by using clinical and hematological septic score.
Preterm neonates were followed up in the NICU for development of BPD defined as oxygen therapy ≥28 days to maintain an adequate range of oxygen saturation.
Those who developed bronchopulmonary dysplasia were included in group 1 (patient group), they were 15 neonates, mean birth weight was 1.26±0.09 (kgm) and mean gestational age was 30.1±1.06 (weeks), while those who did not develop chronic lung disease were included in group 2 (control group), they were 15 neonate, their mean birth weight was 1.41±0.05 (kgm) and mean gestational age was 31.41±0.82 (weeks).
The results showed that:
According to the severity of BPD, 3 cases presented with moderate BPD (20%) and 12 cases with severe BPD (80%), non with mild BPD.
For all VLBW infants with +ve BPD (15), 6 infants died (40%) and 9 infants survived (60%) and needed specific intervention.
There was highly significantly association between BPD and birth weight. Obviously, the smaller birth weight infants, the higher risk for BPD.
There was a highly significantly association between BPD and gestational age. Obviously, the more immature infants, the higher risk for BPD.
There was no significant association between BPD and total fluid intake, while a highly significantly association between BPD and total parentral fluid was detected. Obviously, the more total parentral fluid, the higher risk for BPD.
There was a highly significantly association between BPD and intravenous fluid for parentral drug intake. The more parentral drug infusion, the higher risk for BPD.
There was a significant association between BPD and sodium intake. Over all, the more sodium intake, the higher risk for BPD.
There was a highly significantly association between BPD and enteral intake. Obviously, the less enteral intake, the higher risk for BPD.
There was a significant association between BPD and weight loss. Obviously, the less weight loss, the higher risk for BPD
Apgar score at 1 and 5 minutes, CPAP duration, CPAP FIO2: univariate analysis of these risk factors revealed significant association with development of BPD.
Early sepsis, PDA, blood transfusion and mean PH, mode of delivery, sex, maternal DM, maternal infection, preclamsia, PROM, antepartum Hge, serum Na, serum K: univariate analysis of these risk factors revealed no significant association with development of BPD.
On using stepwise multi regression discriminative analysis, it was found that CPAP duration is a sensitive predictor for BPD.