The role of prophylactic arginine supplementation for prevention of bronchopulmonary dysplasia in extremely preterm infants
In brief
Arginine supplementation linked to 12-point drop in BPD among extremely preterm infants
In a retrospective study of 676 infants born before 29 weeks, any bronchopulmonary dysplasia fell from 85% to 73% after routine arginine for the first 28 days of life was introduced. Adjusted odds of BPD or death also fell, but severe BPD did not; the before-and-after design cannot show that arginine caused the change.
- Journal
- Journal of perinatology : official journal of the California Perinatal Association (Q1)
- Published
- 7 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Stefani M Doucette, Sunil Kumar Jain, Harish Amin, Amina Benlamri, Muhammad Hussain, Selphee Tang, et al.
- PMID
- 42844326
- DOI
- 10.1038/s41372-026-02922-4
Why clinicians should know about it
- Picked for Neonatology (paper of the day, 13 October 2026): Prophylactic arginine reduces BPD odds in <29‑week infants
Abstract
OBJECTIVE: Evaluate association between routine arginine supplementation for the first 28 days of life and incidence of bronchopulmonary dysplasia (BPD) and mortality for preterm infants <29 weeks gestational age (GA). STUDY DESIGN: This retrospective cohort study assessed preterm infants <29 weeks' GA before and after introduction of routine prophylactic arginine supplementation for the first 28 days of life. The primary outcome was bronchopulmonary dysplasia (BPD), defined as oxygen dependency at 36 weeks' postmenstrual age (PMA) and classified by severity using Jensen's criteria. Univariate and multivariable regression analyses were performed. RESULTS: Overall, 676 preterm infants <29 weeks GA were included. The incidence of any BPD decreased from 85% to 73% following introduction of routine arginine supplementation. The adjusted odds ratios (aORs) for any BPD and severe BPD (Grade 2 and 3) were 0.50 (95% CI 0.27-0.90) and 0.94 (95% CI 0.41-2.14), respectively. The composite outcome of BPD or mortality was also reduced (aOR 0.51; 95% CI 0.28-0.91). CONCLUSION: In preterm infants born at <29 weeks' GA, prophylactic arginine supplementation during the first 28 days of life was associated with reduced odds of BPD and the composite outcome of BPD or death before 36 weeks' PMA, but not with severe BPD.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.