Inflammation in the neonatal period and intrauterine growth restriction aggravate bronchopulmonary dysplasia

Hiroaki Kurata; Masayuki Ochiai; Hirosuke Inoue; Takeshi Kusuda; Junko Fujiyoshi; Masako Ichiyama; Yoshifumi Wakata; Hidetoshi Takada

doi:10.1016/j.pedneo.2018.11.007

Inflammation in the neonatal period and intrauterine growth restriction aggravate bronchopulmonary dysplasia

Pediatr Neonatol. 2019 Oct;60(5):496-503. doi: 10.1016/j.pedneo.2018.11.007. Epub 2018 Nov 25.

Authors

Hiroaki Kurata¹, Masayuki Ochiai², Hirosuke Inoue³, Takeshi Kusuda⁴, Junko Fujiyoshi³, Masako Ichiyama³, Yoshifumi Wakata⁵, Hidetoshi Takada⁶

Affiliations

¹ Comprehensive Maternity and Perinatal Care Center, Kyushu University Hospital, Fukuoka, Japan; Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: qurata-kyu@umin.ac.jp.
² Comprehensive Maternity and Perinatal Care Center, Kyushu University Hospital, Fukuoka, Japan; Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: ochimasa@pediatr.med.kyushu-u.ac.jp.
³ Comprehensive Maternity and Perinatal Care Center, Kyushu University Hospital, Fukuoka, Japan; Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Pediatrics, Yamaguchi University, Ube, Japan.
⁵ Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.
⁶ Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

PMID: 31302038
DOI: 10.1016/j.pedneo.2018.11.007

Abstract

Background: To investigate the hematological features of infants with bronchopulmonary dysplasia (BPD) and their relationships with clinical severity.

Methods: This prospective observational study enrolled 73 BPD patients from a total of 331 infants with a birth weight of <1500 g from 2005 to 2013. The clinical severity of BPD was defined by the duration of oxygen supplementation and positive pressure ventilation (PPV) in line with the diagnostic criteria of BPD. The hematological status and cytokine levels were surveyed from blood samples at birth and at 2 and 4 weeks of life.

Results: Thirty-four (46.6%) cases were classified as "moderate-to-severe" BPD. Small-for-gestational-age (SGA) was associated with the severity of BPD (OR: 5.05; 95% CI: 1.45 to 17.2). The CRP level at 2 weeks (partial regression coefficient [rc]: 21.8; 4.01 to 39.7) and the neutrophil count at 4 weeks (0.005; 0.001 to 0.007) were positively correlated with the oxygenation period. The PPV period was found to be correlated with the CRP level at 2 weeks (27.2; 14.9 to 39.5), and the neutrophil count (0.003; 0.001 to 0.004) at 4 weeks.

Conclusion: The aggravation of BPD was associated with both SGA at birth and inflammation during neonatal period.

Keywords: chronic lung disease; etiology; factor; small-for-gestational-age.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Bronchopulmonary Dysplasia / etiology*
Bronchopulmonary Dysplasia / therapy
C-Reactive Protein / analysis
Female
Fetal Growth Retardation*
Humans
Infant
Infant, Newborn
Infant, Small for Gestational Age
Inflammation / complications*
Male
Positive-Pressure Respiration
Prospective Studies

Substances

C-Reactive Protein