Differences in clinical and laboratory biomarkers for short and long‐term respiratory outcomes in preterm neonates

Abstract

Background: Pulmonary outcome of premature neonates has focused more on short-term than long-term respiratory morbidities.Objective: Describe risk factors/biomarkers associated with short-term (bronchopulmonary dysplasia [BPD]) (supplemental oxygen use at 36 weeks postmenstrual age [PMA]) and longer-term (chronic respiratory morbidity [CRM]) (respiratory related symptoms, medications, medical/emergency visits, hospitalizations at 6-12 months corrected gestational age [CGA]) respiratory outcomes in a longitudinal cohort.Design/Methods: Neonates born at 24-29-week gestation were prospectively followed to 6-12-month CGA. Associations between clinical and laboratory risk factors/biomarkers of BPD and CRM were explored.Results: Of 86 subjects, 94% survived. Outcomes were available for 89% at 36-week PMA (BPD present in 42% of infants) and 72% at 6-12-month CGA (CRM present in 47% of infants). For the 54 infants with known outcomes for both BPD and CRM, diagnoses were discordant in 41%. BPD was associated with lower birthweight and birthweight Z-score for GA, lower Apgar scores, more surfactant doses, higher SNAPPE-II scores, highest Day 1 inspired oxygen concentration, Day 7 oxygen use, prolonged ventilatory support, bacteremia, necrotizing enterocolitis, and treated patent ductus arteriosus. CRM was associated with lower Apgar scores, Day 7 oxygen use and higher urine vascular endothelial growth factor. Patterns of plasma and urine lipid oxidation products differed in the two outcomes. Conclusion:In this hypothesis generating and exploratory study, BPD and CRM were associated with different risk factors/biomarker patterns. Concordance between these two outcomes was weak. Strategies for reducing CRM should be studied in cohorts identified by appropriate early risk factors/biomarkers.

Early prediction of bronchopulmonary dysplasia: can noninvasive monitoring methods be essential?

“…Furthermore, 8-OHdG (DOL 14 – 28) levels were shown to be directly correlated with the development of BPD (p<0.05) [ 61 ]. Additionally, one urine lipid oxidation product, 11-dehydro-thromboxane B2 (TXB2), was higher in BPD participants (p=0.05) [ 62 ].…”

Montelukast Sodium to Prevent and Treat Bronchopulmonary Dysplasia in Very Preterm Infants: A Quasi-Randomized Controlled Trial

“…Inclusion criteria included the following: (1) very preterm infants (<32 wk of gestational age) with a very low birth weight (<1500 g for birth weight); (2) preterm infants with BPD risk factors [27][28][29][30], such as <28 wk of gestational age, undergoing continuous mechanical ventilation (MV), non-invasive respiratory support with FiO 2 > 0.3 and a positive end-expiratory pressure of >6 cmH 2 O, or continuous respiratory support with hemodynamically significant patent ductus arteriosus (hsPDA) or sepsis at 7-10 days of life; and (3) written informed parental consent was required.…”