Palivizumab efficacy in preterm infants with gestational age ≤30 weeks without bronchopulmonary dysplasia

2007 ◽  
Vol 42 (3) ◽  
pp. 189-192 ◽  
Author(s):  
Marianne Grimaldi ◽  
Béatrice Gouyon ◽  
Paul Sagot ◽  
Catherine Quantin ◽  
Frédéric Huet ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age

scholarly journals Late hyponatremia: its risk factors in preterm infants and short-term outcome

2021 ◽  
Vol 43 (5) ◽  
pp. 434-443
Author(s):  
Manizheh Gharehbaghi ◽  
Sadollah Yegane Dust ◽  
Elmira Naseri
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Osteopenia Of Prematurity

Background. Prematurity is one of the major health problems and common causes of neonatal mortality. One of the complications of premature infants is hyponatremia. The effect of hyponatremia on the prognosis of preterm infants has not been well studied. This study aimed to evaluate infants with late hyponatremia, its risk factors, and prognosis. Methods. This descriptive analytical study reviewed preterm infants (<34 weeks) admitted to Al-Zahra or Children’s Hospital in Tabriz for one year (2019). Neonates diagnosed with hyponatremia after the second week were identified and evaluated for risk factors and short-term outcome. Results. A total of 186 neonates were studied. The mean gestational age of the neonates was 30 weeks (first and third quarters = 29-32 weeks). 101 (54.3%) infants were male. The route of delivery was the cesarean section in 60.7% of cases. Late hyponatremia was present in 50 (26.8 %) infants. Gestational age and birth weight were significantly lower in infants with hyponatremia than in the control group. Multivariate analysis showed that low birth weight, the use of prenatal steroids, and inappropriate weight for gestational age status independently predict the incidence of late hyponatremia. There was a significant relationship between the presence of prolonged late hyponatremia (over 7 days) and bronchopulmonary dysplasia and osteopenia of prematurity. However, no significant association was found between the presence of prolonged late hyponatremia in preterm infants with the length of hospital stay and in-hospital mortality. Conclusion. Based on the findings of this study, low birth weight, prenatal steroid use, and lack of appropriate weight for gestational age were risk factors for late hyponatremia in preterm infants. Prolonged hyponatremia is associated with bronchopulmonary dysplasia and osteopenia of prematurity

scholarly journals The Correlation Between Bronchopulmonary Dysplasia and Platelet Metabolism in Preterm Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Longli Yan ◽  
Zhuxiao Ren ◽  
Jianlan Wang ◽  
Xin Xia ◽  
Liling Yang ◽  
...  
Keyword(s):  
Platelet Count ◽  
Birth Weight ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Gestational Age ◽  
Admission Diagnosis ◽  
Control Group ◽  
The Relationship

Background: Platelets play an important role in the formation of pulmonary blood vessels, and thrombocytopenia is common in patients with pulmonary diseases. However, a few studies have reported on the role of platelets in bronchopulmonary dysplasia.Objective: The objective of the study was to explore the relationship between platelet metabolism and bronchopulmonary dysplasia in premature infants.Methods: A prospective case-control study was performed in a cohort of premature infants (born with a gestational age &lt;32 weeks and a birth weight &lt;1,500 g) from June 1, 2017 to June 1, 2018. Subjects were stratified into two groups according to the diagnostic of bronchopulmonary dysplasia: with bronchopulmonary dysplasia (BPD group) and without bronchopulmonary dysplasia (control group). Platelet count, circulating megakaryocyte count (MK), platelet-activating markers (CD62P and CD63), and thrombopoietin (TPO) were recorded and compared in two groups 28 days after birth; then serial thrombopoietin levels and concomitant platelet counts were measured in infants with BPD.Results: A total of 252 premature infants were included in this study. Forty-eight premature infants developed BPD, 48 premature infants without BPD in the control group who were matched against the study infants for gestational age, birth weight, and admission diagnosis at the age of postnatal day 28. Compared with the controls, infants with BPD had significantly lower peripheral platelet count [BPD vs. controls: 180.3 (24.2) × 109/L vs. 345.6 (28.5) × 109/L, p = 0.001]. Circulating MK count in the BPD group was significantly more abundant than that in the control group [BPD vs. controls: 30.7 (4.5)/ml vs. 13.3 (2.6)/ml, p = 0.025]. The level of CD62p, CD63, and TPO in BPD group was significantly higher than the control group [29.7 (3.1%) vs. 14.5 (2.5%), 15.4 (2.0%) vs. 5.8 (1.7%), 301.4 (25.9) pg/ml vs. 120.4 (14.2) pg/ml, all p &lt; 0.05]. Furthermore, the concentration of TPO was negatively correlated with platelet count in BPD group with thrombocytopenia.Conclusions: Our findings suggest that platelet metabolism is involved in the development of BPD in preterm infants. The possible mechanism might be through increased platelet activation and promoted TPO production by feedback.

scholarly journals Serum Periostin Levels at Birth as a Predictor for Bronchopulmonary Dysplasia in Premature Infants.

2020 ◽  
Author(s):  
Hayato Go ◽  
Junya Ono ◽  
Hitoshi Ohto ◽  
Kenneth E. Nollet ◽  
Kenichi Sato ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Area Under The Curve ◽  
Enzyme Linked Immunosorbent Assay ◽  
Characteristic Analysis ◽  
Factors Affecting ◽  
Healthy Infants ◽  
Median Serum ◽  
Serum Periostin

Abstract Background: Bronchopulmonary dysplasia (BPD) is the most common morbidity complicating preterm birth and affects long-term respiratory outcomes. Periostin plays an important role in the development of various disease such as allergic and pulmonary diseases. The objectives of this study were to evaluate the perinatal factors affecting serum periostin levels at birth and to establish whether serum periostin at birth, day of life (DOL) 28 and corrected 36 week’s gestational age could be potential biomarkers for BPD.Methods: A total of 139 preterm (n=98) and healthy (n=41) infants were included in this study. Among of them, 98 infants born < 32 weeks were divided into BPD (n=44) and non-BPD infants (n=54). Serum periostin levels were measured using an enzyme-linked immunosorbent assay. Results: The median serum periostin levels at birth in preterm infants born < 32 weeks were significantly higher than those in healthy infants. Furthermore, there were significant inverse correlations between gestational age, birth weight, and serum periostin levels at birth among all 139 preterm and healthy infants. Among preterm infants born < 32 weeks, with BPD and without BPD infants, the median serum periostin levels at birth were higher with BPD than without (345.0 ng/mL vs 278.0 ng/mL, P=0.002). Multivariate analysis revealed that serum periostin levels at birth was significantly associated with BPD (P=0.032). Receiver operating characteristic analysis for serum periostin levels at birth in infants with and without BPD revealed that the area under the curve were 0.725 (95% CI 0.627- 0.822, P=0.0001). Serum periostin levels at birth with moderate/severe BPD were significantly higher than those with non-BPD/mild BPD (338.5 ng/mL vs 283.5 ng/mL, P=0.0032).Conclusions: Serum periostin levels at birth were significantly correlated with BW and GA. Furthermore, serum periostin levels at birth could serve as a biomarker for predicting BPD.

scholarly journals Systematic review of the healthcare cost of bronchopulmonary dysplasia

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045729
Author(s):  
Jhangir Humayun ◽  
Chatarina Löfqvist ◽  
David Ley ◽  
Ann Hellström ◽  
Hanna Gyllensten
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
First Year ◽  
Long Term Follow Up ◽  
First Year Of Life

ObjectivesTo determine the costs directly or indirectly related to bronchopulmonary dysplasia (BPD) in preterm infants. The secondary objective was to stratify the costs based on gestational age and/or birth weight.DesignSystematic literature review.SettingPubMed and Scopus were searched on 3 February 2020. Studies were selected based on eligibility criteria by two independent reviewers. Included studies were further searched to identify eligible references and citations.Two independent reviewers extracted data with a prespecified data extraction sheet, including items from a published checklist for quality assessment. The costs in the included studies are reported descriptively.Primary outcome measureCosts of BPD.ResultsThe 13 included studies reported the total costs or marginal costs of BPD. Most studies reported costs during birth hospitalisation (cost range: Int$21 392–Int$1 094 509 per child, equivalent to €19 103–€977 397, in 2019) and/or during the first year of life. One study reported costs during the first 2 years; two other studies reported costs later, during the preschool period and one study included a long-term follow-up. The highest mean costs were associated with infants born at extremely low gestational ages. The quality assessment indicated a low risk of bias in the reported findings of included studies.ConclusionsThis study was the first systematic review of costs associated with BPD. We confirmed previous reports of high costs and described the long-term follow-up necessary for preterm infants with BPD, particularly infants of very low gestational age. Moreover, we identified a need for studies that estimate costs outside hospitals and after the first year of life.PROSPERO registration numberCRD42020173234.

Chronic Inflammatory Placental Lesions Correlate With Bronchopulmonary Dysplasia Severity in Extremely Preterm Infants

2021 ◽  
pp. 109352662110136
Author(s):  
Amit Sharma ◽  
Beena G Sood ◽  
Faisal Qureshi ◽  
Yuemin Xin ◽  
Suzanne M Jacques
Keyword(s):  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Group Development ◽  
Respiratory Support ◽  
Placental Pathology ◽  
Inflammatory Lesions ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Objective Correlation of BPD with placental pathology is important for clarification of the multifactorial pathogenesis of BPD; however, previous reports have yielded varying results. We report placental findings in no/mild BPD compared to moderate/severe BPD, and with and without pulmonary hypertension (PH). Methods Eligible infants were 230/7-276/7 weeks gestational age. BPD was defined by the need for oxygen at ≥28 days with severity based on need for respiratory support at ≥36 weeks. Acute and chronic inflammatory placental lesions and lesions of maternal and fetal vascular malperfusion were examined. Results Of 246 eligible infants, 146 (59%) developed moderate/severe BPD. Thirty-four (23%) infants developed PH, all but 1 being in the moderate/severe BPD group. Chronic deciduitis (32% vs 16%, P = .003), chronic chorioamnionitis (23% vs 12%, P = .014), and ≥ 2 chronic inflammatory lesions (13% vs 3%, P = .007) were more frequent in the moderate/severe BPD group. Development of PH was associated with placental villous lesions of maternal vascular malperfusion (30% vs 15%, P = .047). Conclusions The association of chronic inflammatory placental lesions with BPD severity has not been previously reported. This supports the injury responsible for BPD as beginning before birth in some neonates, possibly related to cytokines associated with these chronic inflammatory lesions.

Validation of ICD-9 diagnostic codes for bronchopulmonary dysplasia in Quebec's provincial health care databases

2012 ◽  
Vol 33 (1) ◽  
pp. 47-52 ◽  
Author(s):  
JS Landry ◽  
D Croitoru ◽  
D Menzies
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Administrative Databases ◽  
Medical Services ◽  
Care Utilization ◽  
Lower Sensitivity ◽  
Diagnostic Codes

Introduction Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by neonatal lung injury. The aim of this study was to validate the use of ICD-9 diagnostic codes for BPD in administrative databases to allow for their use in health care utilization analyses. Methods The validation process used a retrospective cohort composed of preterm infants, with or without respiratory complications, admitted to the Montréal Children's Hospital, Montréal, Quebec, between 1983 and 1992. BPD subjects were identified using ICD-9 diagnostic codes in the provincial administrative databases (medical services and MED-ECHO) and then matched with subjects with confirmed BPD from the validation cohort. We examined concordance and estimated sensitivity and specificity associated with the use of these diagnostic codes for BPD. Results True positive and false negative BPD subjects did not differ significantly according to gestational age, birth weight and Apgar scores. False positive BPD subjects were found to have significantly lower gestational age than true negative subjects. The use of the ICD-9 diagnostic codes for BPD was associated with a specificity between 97.6% and 98.0%. The sensitivity was lower at 45.0% and 52.4% for the medical services and MED-ECHO databases, respectively. Milder cases of BPD tended to be missed more frequently than more severe cases. Conclusion The specificity of the use of ICD-9 diagnostic codes for BPD in the Quebec provincial health care databases is adequate to allow its routine use. Its lower sensitivity for milder cases will likely result in an underestimation of the impacts of BPD on the long-term health care utilization of preterm infants.

Below median birth weight in appropriate-for-gestational-age preterm infants as a risk factor for bronchopulmonary dysplasia

2008 ◽  
Vol 36 (4) ◽  
Author(s):  
Gabriele Kewitz ◽  
Stefan Wudel ◽  
Hartmut Hopp ◽  
Werner Hopfenmüller ◽  
Martin Vogel ◽  
...  
Keyword(s):  
Risk Factor ◽  
Birth Weight ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Appropriate For Gestational Age ◽  
Median Birth Weight

scholarly journals BNP, troponin I, and YKL-40 as screening markers in extremely preterm infants at risk for pulmonary hypertension associated with bronchopulmonary dysplasia

2016 ◽  
Vol 311 (6) ◽  
pp. L1076-L1081 ◽  
Author(s):  
Kai König ◽  
Katelyn J. Guy ◽  
Claudia A. Nold-Petry ◽  
Charles P. Barfield ◽  
Geraldine Walsh ◽  
...  
Keyword(s):  
At Risk ◽  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Troponin I ◽  
Systolic Pressure ◽  
Ventricular Systolic Pressure ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28-wk gestation and still inpatients at 36-wk corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40. Infants were analyzed according to echocardiographic evidence of tricuspid regurgitation (TR). Thirty infants had evidence of TR on echocardiogram at 36-wk corrected age. Infants with or without TR had similar baseline demographics: mean ± SD gestational age 261 ± 12 vs. 261 ± 11 wk and birth weight 830 ± 206 vs. 815 ± 187 g, respectively. There was no difference in duration of respiratory support. The right ventricular systolic pressure of infants with evidence of TR was 40 ± 16 mmHg. BNP was the only biomarker that proved to be significantly higher in infants with evidence of TR: median (interquartile range) serum level 54.5 (35–105) vs. 41.5 (30–59) pg/ml, P = 0.043. Subgroup analysis of infants with severe BPD requiring discharge on home oxygen or BPD-related mortality revealed similar results. There was no difference between groups for troponin I and YKL-40. In conclusion, increased serum levels of BNP were associated with evidence of TR at 36-wk corrected gestational age in extremely preterm infants, suggesting a potential role as a screening biomarker for BPD-associated PH.

scholarly journals Biomarker Potential of the Soluble Receptor for Advanced Glycation End Products to Predict Bronchopulmonary Dysplasia in Premature Newborns

2021 ◽  
Vol 9 ◽  
Author(s):  
Hayato Go ◽  
Hitoshi Ohto ◽  
Kenneth E. Nollet ◽  
Kenichi Sato ◽  
Kyohei Miyazaki ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Advanced Glycation End Products ◽  
Gestational Age ◽  
Enzyme Linked Immunosorbent Assay ◽  
Soluble Receptor ◽  
Advanced Glycation ◽  
Characteristic Analysis ◽  
Glycation End Products ◽  
End Products

Bronchopulmonary dysplasia (BPD) is a common cause of pulmonary disease in preterm infants. The soluble receptor for advanced glycation end products (sRAGE) is implicated in the development of various pulmonary diseases. The objectives of the current study were to investigate perinatal factors associated with serum sRAGE levels at birth and to establish whether serum sRAGE could be a biomarker for BPD. This retrospective single-center study was conducted at Fukushima Medical University Hospital's Department of Pediatrics Neonatal Intensive Care Unit from April 2014 to September 2020. Mechanically ventilated or oxygenated neonates born at &lt;32 weeks gestational age and healthy control neonates were included in this study. Serum sRAGE levels in cord blood were measured using an enzyme-linked immunosorbent assay. Eighty-four preterm infants born at &lt;32 weeks and 40 healthy infants were identified. The 84 born at &lt;32 weeks were categorized as BPD (n = 34) or non-BPD (n = 50) neonates. The median gestational age (GA) and birthweight (BW) were significantly lower in BPD vs. non-BPD neonates (24.4 vs. 27.6 weeks, P &lt; 0.001, 634 vs. 952 g, P &lt; 0.001, respectively). Serum sRAGE at birth in all 124 preterm and term infants significantly correlated with BW (r = 0.417, P &lt; 0.0001) and GA (r = 0.415, P &lt; 0.0001). Among those born at &lt;32 weeks, median serum sRAGE levels at birth were significantly lower in infants with BPD than without (1,726 vs. 2,797 pg/mL, P = 0.0005). Receiver operating characteristic analysis for sRAGE levels at birth in infants with and without BPD revealed that the area under the curve was 0.724 (95% confidence interval 0.714–0.834, P = 0.001). However, serum RAGE levels were not associated with severity of BPD. Serum sRAGE levels at birth were significantly correlated with BW and GA. Furthermore, serum sRAGE levels at birth could serve as a biomarker for predicting BPD, but not its severity.

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