This retrospective cohort evaluated the relationship between bronchopulmonary dysplasia (BPD) severity and post-discharge growth across the first year of corrected age in very preterm infants. The primary aim was to determine whether BPD severity is associated with persistent deficits in weight, length, and head circumference and whether it affects recovery from growth failure identified at hospital discharge.
The study included 1,106 infants born before 32 weeks' gestation. BPD severity was assigned using the Jensen definition and categorized as no BPD (n = 768), mild BPD (n = 142), moderate BPD (n = 154), and severe BPD (n = 42). The cohort was followed from birth to 12 months corrected age, with anthropometric assessments at discharge and longitudinally through the first year.
Weight, length, and head circumference z-scores were computed and tracked from birth through 12 months corrected age. The investigators used adjusted longitudinal models to evaluate growth trajectories across BPD severity groups and survival-type models to estimate time to recovery from growth failure at discharge. Recovery probabilities at 12 months and hazard ratios (HR) for time to recovery were reported for weight, length, and head circumference among infants who had growth failure at discharge.
Across all anthropometric domains, increasing BPD severity was associated with progressively poorer outcomes at both discharge and 12 months (all p < 0.001). After adjustment, severe BPD remained independently associated with lower z-scores at 12 months for:
These adjusted estimates indicate that infants with severe BPD had persistent deficits in weight, linear growth, and head growth at 12 months corrected age relative to infants with less or no BPD.
Among the subgroup of infants who had established growth failure at hospital discharge, BPD severity predicted the rate of subsequent growth recovery. Specifically, compared with infants without severe BPD, those with severe BPD showed significantly slower recovery:
For infants with severe BPD, the median time to recovery was not reached for any anthropometric domain within the first year. Reported 12-month recovery probabilities in the severe-BPD group were 41.3% for weight, 42.6% for length, and 30.1% for head circumference.
The study demonstrates that severe BPD is independently associated with sustained impairments in weight, length, and head circumference and with substantially delayed recovery from growth failure during infancy. Based on these findings, the authors recommend structured longitudinal growth monitoring and targeted nutritional follow-up after discharge for infants with BPD, particularly those with severe disease.
These results highlight the need for post-discharge care pathways that include regular anthropometric assessment and nutritional interventions tailored to preterm infants with BPD to support catch-up growth in the first year corrected age.
Ethical approval for the retrospective data collection and analysis was obtained from the King Abdullah International Medical Research Centre (KAIMRC), IRB approval number NRR26/133/1. Because the study used fully de-identified clinical data and was retrospective, the requirement for informed consent was waived. The authors declared no competing interests.
Note: Details beyond those reported in the published abstract — such as full covariates included in adjusted models, subgroup characteristics, or exact follow-up visit schedule — were not reported in the source abstract and therefore are not summarized here.