Differences in clinical and laboratory biomarkers for short and long-term respiratory outcomes in preterm neonates.
bronchopulmonary dysplasia (BPD)
chronic respiratory morbidity (CRM)
epidemiology
neonatal lung disease
neonatal pulmonary
preterm neonates
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
10
08
2021
received:
08
04
2021
accepted:
11
08
2021
pubmed:
27
8
2021
medline:
25
12
2021
entrez:
26
8
2021
Statut:
ppublish
Résumé
Pulmonary outcome of premature neonates has focused more on short-term than long-term respiratory morbidities. 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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 34437765
doi: 10.1002/ppul.25630
pmc: PMC8630934
mid: NIHMS1733488
doi:
Substances chimiques
Biomarkers
0
Vascular Endothelial Growth Factor A
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
3847-3856Subventions
Organisme : NCRR NIH HHS
ID : UL1 RR025752
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025758
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002544
Pays : United States
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Pediatr Res. 2010 Feb;67(2):144-9
pubmed: 19809377
J Perinatol. 2003 Sep;23(6):451-6
pubmed: 13679930
J Pediatr. 2014 Aug;165(2):240-249.e4
pubmed: 24725582
J Perinatol. 2008 Dec;28(12):837-40
pubmed: 19034291
J Pediatr. 2018 Dec;203:234-241.e2
pubmed: 30287068
Semin Perinatol. 2018 Nov;42(7):413-424
pubmed: 30389227
J Matern Fetal Neonatal Med. 2016 Dec;29(24):3934-8
pubmed: 26988271
J Perinatol. 2015 May;35(5):313-321
pubmed: 25811285
J Chromatogr B Analyt Technol Biomed Life Sci. 2004 Jan 25;799(2):245-54
pubmed: 14670743
Neonatology. 2013;104(1):56-64
pubmed: 23711562
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
J Pediatr. 2001 Jan;138(1):92-100
pubmed: 11148519
Hum Pathol. 1994 Apr;25(4):379-85
pubmed: 8163271
Nutrients. 2018 Feb 20;10(2):
pubmed: 29461479
Semin Fetal Neonatal Med. 2009 Dec;14(6):358-66
pubmed: 19783238
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Pediatr Res. 2019 Aug;86(2):254-260
pubmed: 31086287
Pediatrics. 1975 Jan;55(1):55-8
pubmed: 234187
J Pediatr. 2017 Aug;187:89-97.e3
pubmed: 28528221
Pediatrics. 2004 Nov;114(5):1305-11
pubmed: 15520112
J Pediatr. 2018 Jun;197:300-308
pubmed: 29551318
JAMA Netw Open. 2019 Nov 1;2(11):e1914611
pubmed: 31693123
Natl Vital Stat Rep. 2018 Nov;67(8):1-50
pubmed: 30707672
J Pediatr. 2017 Dec;191:15-21.e1
pubmed: 29173299
Am J Respir Crit Care Med. 2002 Apr 15;165(8):1093-7
pubmed: 11956050
Pediatrics. 2005 Dec;116(6):1353-60
pubmed: 16322158
Am J Obstet Gynecol. 2008 Sep;199(3):256.e1-9
pubmed: 18771974
Antioxid Redox Signal. 2015 Jul 10;23(2):178-84
pubmed: 25714759
Neonatology. 2015;107(4):241-8
pubmed: 25765705
JAMA. 2015 Sep 8;314(10):1039-51
pubmed: 26348753
J Pharmacol Exp Ther. 2001 Feb;296(2):293-305
pubmed: 11160610
Pediatrics. 2003 Mar;111(3):469-76
pubmed: 12612223