Interaction of Target Oxygen Saturation, Bronchopulmonary Dysplasia, and Pulmonary Hypertension in Small for Gestational Age Preterm Neonates

2016 ◽  
Vol 170 (8) ◽  
pp. 807 ◽  
Author(s):  
Satyan Lakshminrusimha ◽  
Veena Manja ◽  
Robin H. Steinhorn
Keyword(s):  
Pulmonary Hypertension ◽  
Oxygen Saturation ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Preterm Neonates

scholarly journals Cord Blood Levels of IL-6, IL-8 and IL-10 May Be Early Predictors of Bronchopulmonary Dysplasia in Preterm Newborns Small for Gestational Age

2012 ◽  
Vol 33 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Gustavo Rocha ◽  
Elisa Proença ◽  
Ana Guedes ◽  
Carmen Carvalho ◽  
Augusta Areias ◽  
...  
Keyword(s):  
Cord Blood ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Preterm Neonates ◽  
Blood Levels ◽  
Early Predictors ◽  
Blood Cytokines ◽  
Uterine Growth ◽  
Preterm Newborns

Introduction: Various cytokines have been associated to the occurrence of bronchopulmonary dysplasia (BPD) in preterm neonates.AIM: To establish an association between cord blood cytokines and BPD, so that they could be used, in clinical practice, as early markers of BPD.Material and methods: Preterms less than 30 weeks gestational age, were analysed by ELISA microassay for venous cord blood IL-1β, IL-6, IL-8, TNF-αand IL-10, and compared between the BPD and non-BPD groups.Results: One hundred and fifty neonates completed the study; 31 (21%) small for gestational age (SGA); 16 were deceased before 28 days of life; 36 developed mild BPD and 20 developed moderate/severe BPD. Elevated cord blood IL-8 was associated with death or moderate/severe BPD. SGA patients with moderate/severe BPD presented higher cord blood values of IL-8, lower IL-6 and IL-10 when compared with SGA without moderate/severe BPD; and higher IL-8 levels when compared with patients without moderate/severe BPD.Conclusion: These results support an association between cord blood IL-8 and moderate/severe BPD, independently of the intra-uterine growth; and the association of cord blood IL-6 and IL-10 and moderate/severe BPD in SGA preterm newborns.

scholarly journals The impact of placental pathology discordance in multiple gestation pregnancies on bronchopulmonary dysplasia-associated pulmonary hypertension

2020 ◽  
Vol 10 (1) ◽  
pp. 204589402091067
Author(s):  
Andrew Franklin ◽  
Sushmita Yallapragada ◽  
Robert Birkett ◽  
William Grobman ◽  
Linda M. Ernst ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Chronic Hypertension ◽  
Multiple Gestation ◽  
Placental Pathology ◽  
Angiogenic Growth Factors ◽  
Increased Risk ◽  
The Impact

Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) may either be concordant or discordant between multiple gestation births. Abnormal placental development, particularly maternal vascular malperfusion, may account for discordance in BPD-PH through fetal programming mechanisms. Maternal vascular malperfusion is a placental histologic lesion associated with intrauterine growth restriction and BPD-PH. We conducted a retrospective longitudinal cohort study of infants born <29 weeks gestation with available placental histology at Prentice Women's Hospital in Chicago from 2005–2012. The primary outcome was discordant BPD-PH associated with placental maternal vascular malperfusion. We secondarily assessed whether the risk of BPD-PH and placental lesions was different among infants of multiple (compared to singleton) gestations. The cohort consisted of 135 multiple gestation infants and 355 singletons. In a separate cohort of 39 singletons and 35 multiples, associations between 12 cytokines and angiogenic growth factors in cord blood plasma for biomarker discordance, maternal vascular malperfusion, and bronchopulmonary dysplasia were explored. Among multiples, discordant maternal vascular malperfusion was not associated with BPD-PH (OR = 1.9 (0.52, 6.9); p = 0.33) in infants exposed to placental maternal vascular malperfusion. However, singleton infants were more likely to develop BPD-PH (compared to multiples) after adjusting for mode of delivery, chorioamnionitis, chronic hypertension, placental abruption, small-for-gestational age birth weight, and gestational age (aOR = 2.7 (1.2, 5.8); p = 0.038). Singletons were more likely to be small-for-gestational age (11% vs 4%, p = 0.025) and have placental lesions compared to their multiple-gestation counterparts (96% vs 81%, p < 0.001), principally severe maternal vascular malperfusion (17% vs 4%, p < 0.001) and chronic inflammation (32% vs 11%, p < 0.001). Increased risk of BPD-PH in singleton pregnancies <29 weeks gestation compared to multiples may be related to increased frequency of these histologic lesions. Placental pathology in singleton and multiple gestation pregnancies may serve as an early biomarker to predict BPD-PH.

scholarly journals Risk Factors and Outcomes of Pulmonary Hypertension in Infants With Bronchopulmonary Dysplasia: A Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Ying Chen ◽  
Di Zhang ◽  
Ying Li ◽  
Aixia Yan ◽  
Xiaoying Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Meta Analysis ◽  
Total Duration ◽  
Morbidity And Mortality ◽  
Meta Analyses

Background: Pulmonary hypertension is one of the most common co-morbidities in infants with bronchopulmonary dysplasia (BPD), but its risk factors are unclear. The onset of pulmonary hypertension in BPD has been associated with poor morbidity- and mortality-related outcomes in infants. Two review and meta-analysis studies have evaluated the risk factors and outcomes associated with pulmonary hypertension in infants with BPD. However, the limitations in those studies and the publication of recent cohort studies warrant our up-to-date study. We designed a systematic review and meta-analysis to evaluate the risk factors and outcomes of pulmonary hypertension in infants with BPD.Objective: To systematically evaluate the risk factors and outcomes associated with pulmonary hypertension in infants with BPD.Methods: We systematically searched the academic literature according to the PRISMA guidelines across five databases (Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE). We conducted random-effects meta-analyses to evaluate the pulmonary hypertension risk factors in infants with BPD. We also evaluated the overall morbidity- and mortality-related outcomes in infants with BPD and pulmonary hypertension.Results: We found 15 eligible studies (from the initial 963 of the search result) representing data from 2,156 infants with BPD (mean age, 25.8 ± 0.71 weeks). The overall methodological quality of the included studies was high. Our meta-analysis in infants with severe BPD revealed increased risks of pulmonary hypertension [Odds ratio (OR) 11.2], sepsis (OR, 2.05), pre-eclampsia (OR, 1.62), and oligohydramnios (OR, 1.38) of being small for gestational age (3.31). Moreover, a comparative analysis found medium-to-large effects of pulmonary hypertension on the total duration of hospital stay (Hedge's g, 0.50), the total duration of oxygen received (g, 0.93), the cognitive score (g, −1.5), and the overall mortality (g, 0.83) in infants with BPD.Conclusion: We identified several possible risk factors (i.e., severe BPD, sepsis, small for gestational age, pre-eclampsia) which promoted the onset of pulmonary hypertension in infants with BPD. Moreover, our review sheds light on the morbidity- and mortality-related outcomes associated with pulmonary hypertension in these infants. Our present findings are in line with the existing literature. The findings from this research will be useful in development of efficient risk-based screening system that determine the outcomes associated with pulmonary hypertension in infants with BPD.

scholarly journals The influence of small for gestational age status on outpatient bronchopulmonary dysplasia outcomes

2014 ◽  
Vol 35 (1) ◽  
pp. 72-76 ◽  
Author(s):  
J Johnson ◽  
T Ryan ◽  
A D Aherrera ◽  
S A McGrath-Morrow ◽  
J M Collaco
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Small For Gestational Age

BREASTFEEDING AUGMENTS METABOLIC ADAPTATION IN SMALL FOR GESTATIONAL AGE AND PRETERM NEONATES

1998 ◽  
Vol 44 (3) ◽  
pp. 441-441 ◽  
Author(s):  
L J De Rooy ◽  
S M Lawrence ◽  
J G Michelback ◽  
J M Hawdon ◽  
A F Williams
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Metabolic Adaptation ◽  
Preterm Neonates

scholarly journals Vγ9Vδ2-T lymphocytes have impaired antiviral function in small-for-gestational-age and preterm neonates

2013 ◽  
Vol 10 (3) ◽  
pp. 253-260 ◽  
Author(s):  
Jinrong Li ◽  
Hong Li ◽  
Huawei Mao ◽  
Meixing Yu ◽  
Ting Feng ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Preterm Neonates ◽  
Antiviral Function

scholarly journals Right ventricular function in infants with bronchopulmonary dysplasia and pulmonary hypertension: a pilot study

2018 ◽  
Vol 9 (1) ◽  
pp. 204589401881606 ◽  
Author(s):  
Arabella J. Blanca ◽  
Liesbeth Duijts ◽  
Esther van Mastrigt ◽  
Marielle W. Pijnenburg ◽  
Derk-Jan D. Ten Harkel ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Structure And Function ◽  
Systolic Strain ◽  
Cardiac Structure And Function ◽  
Myocardial Structure ◽  
And Function

Premature birth and bronchopulmonary dysplasia (BPD) are risk factors for the development of echocardiographic signs of pulmonary hypertension (PH) and are associated with changes in cardiac structure and function. It is unclear whether this association persists beyond early infancy. The aims of this study are to prospectively investigate the prevalence of PH in children with severe BPD and to investigate the effect of BPD and PH on myocardial structure and function at six months corrected age. Preterm infants (gestational age ≤ 32 weeks) with severe BPD were included. Echocardiography was used to define PH and to measure speckle tracking derived longitudinal and circumferential strain of the left ventricle (LV) and right ventricle (RV). Sixty-nine infants with a median (interquartile range [IQR]) gestational age of 25.6 (24.9–26.4) weeks and a median birthweight of 770 (645–945) gram were included. Eight (12%) infants had signs of PH at six months corrected age. RV fractional area change was lower in infants with severe BPD and PH at six months compared to infants without PH (35% ± 9% vs. 43% ± 9%, P = 0.03). RV mean longitudinal systolic strain was lower in infants with severe BPD and PH compared to infants without PH (17.6% [−19.5%/−16.1%] vs. −20.9% [−25.9%/−17.9%], P = 0.04). RV size and LV longitudinal and circumferential strain in children with BPD with or without PH were similar. Signs of PH were found in 12% of infants with severe BPD at six months corrected age and the presence of PH is associated with reduced RV systolic function.

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