Extrauterine growth restriction and low energy intake during the early neonatal period of very low birth weight infants are associated with decreased lung function in childhood.

Premature birth, bronchopulmonary dysplasia or restrictive nutrition in the first weeks of postnatal life may have repercussions on lung development and affect long-term lung function outcomes. This prospective observational study is based on a cohort of 313 very-low-birth-weight (VLBW) neonates, born between 1 January 2008 and 1 December 2016. The daily intake of calories, protein, fat and carbohydrates during the first week of life and evidence of inadequate weight gain (Δwt) until week 36 of gestational age (GA) were recorded. FEV 1 , FEF 25-75% , FVC and the FEV 1 /FVC ratio were determined. The relations between these parameters were determined by regression analysis. Spirometric parameters were obtained for 141 children with a mean age of 9 years (95% CI 7 - 11); 69 of them (48.9%) had presented wheezing episodes on more than three occasions. In addition, 60 (42.5%) had a history of BPD. Of these, n=40 (66.6%) had a history of wheezing. A significant association was observed between protein/energy intake in the first week of life and the lung function parameters analysed. Poor Δwt to GA week 36 was significantly associated with decreased mean pulmonary flow.Inadequate protein/energy intake in the first week of life of VLBW newborns and poor Δwt to week 36 of GA are associated with a significant worsening of lung function parameters.