scholarly journals Cytokines and Exhaled Nitric Oxide Are Risk Factors in Preterm Infants for Bronchopulmonary Dysplasia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhenjie Zhang ◽  
Wuchen Wu ◽  
Lian Hou ◽  
Jingjing Jiang ◽  
Weilin Wan ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Mechanical Ventilation ◽  
High Risk ◽  
Disease Severity ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Exhaled Nitric Oxide ◽  
High Risk Factors ◽  
Tnf Α

Bronchopulmonary dysplasia (BPD) is the most common complication of extremely preterm birth. This study was aimed at detecting cytokine and fractional exhaled nitric oxide (FeNO) levels to evaluate their mechanisms and predicted significance for BPD. Preterm infants born at g e s t a t i o n a l   a g e ≤ 32   w e e k s were recruited, and clinical data were collected. We detected ten cytokines, including IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8, and TNF-α on Days 1–3, Days 7–14, and Days 21–28 after birth by using the Meso Scale Discovery (MSD) technology. The FeNO levels of infants were measured when they met the discharge criteria. A total of 46 preterm infants were enrolled, consisting of 14 infants in BPD group and 32 infants in the control group. The gestational age ( 27.5 ± 1.3 vs. 29.9 ± 1.3 weeks) and birth weight ( 1021 ± 261  g vs. 1489 ± 357 g) were lower in the BPD group. The following were high-risk factors for BPD, as determined by multivariate logistic regression analysis: g e s t a t i o n a l   a g e < 30   w e e k s , b i r t h   w e i g h t < 1000   g , PDA, longer mechanical ventilation, and higher FeNO. The cytokines of IL-6 and IL-8 on Days 7–14 and IL-4, IL-6, IL-8, and TNF-α on Days 21–28 were also high-risk factors for BPD. IL-6 contributed to BPD disease severity. Conclusion. The preterm infants with PDA and prolonged mechanical ventilation tended to develop BPD. The IL-6 and IL-8 were significantly increased on Days 7–14 and were high-risk factors for BPD. Moreover, the IL-6 level was associated with BPD disease severity. We speculated that NO was related to BPD via Th2 cell-mediated inflammatory responses such as IL-4 and IL-6. Cytokines might predict the occurrence of BPD.

scholarly journals The Cytokines, Exhaled Nitric Oxide are Risk Factors in Preterm Infants for Bronchopulmonary Dysplasia

2020 ◽  
Author(s):  
Zhenjie Zhang ◽  
Wuchen Wu ◽  
Lian Hou ◽  
Jingjing Jiang ◽  
Yunwei Li ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Mechanical Ventilation ◽  
Birth Weight ◽  
High Risk ◽  
Preterm Infants ◽  
Gestational Age ◽  
Control Group ◽  
High Risk Factors ◽  
Tnf Α

Abstract Background Bronchopulmonary dysplasia (BPD) remains the most frequently complication of extreme preterm infants. Multiple clinical factors and inflammatory markers have all been associated with BPD. Therefore, this study targeted to detect cytokines and fractional exhaled nitric oxide(FeNO) to evaluate their mechanism and possible predicted significance for BPD. Methods Preterm infants born at gestational age ≤ 32 weeks were recruited between January 2018 and October 2019. The clinical data of infant characteristics and maternal characteristics were collected. Our study detected a total of ten cytokines include IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8 and TNF-α on day 1–3, day 7–14, and day 21–28 after birth via Meso Scale Discovery (MSD) technology. FeNO levels were measured when the infants met discharge criteria. Results A total of 46 preterm infants were enrolled in this study, including 14 infants in BPD group and 32 infants in control group. The gestational age 【(27.5 ± 1.3) vs. (29.9 ± 1.3) weeks】and birth weight【(1021 ± 261)g vs. (1489 ± 357)g】of BPD group were lower than those of control group. Multivariate logistic regression analysis showed that gestational age < 30 weeks, birth weight < 1000 g, PDA, longer mechanical ventilation and invasive ventilation duration were high risk factors for BPD. The cytokines of IL-6, IL-8 on day 7–14 and IL-4, IL-6, IL-8, TNF-α on day 21–28 were also the high risk factors for BPD. Other risk factors for BPD included elevated Eosnophils on day 21–28 and FeNO. Conclusion The preterm infants with PDA, prolonged mechanical ventilation tended to develop BPD. The FeNO, Eosnophils, cytokines such as IL-4, IL-6, IL-8, TNF-α were high risk factors for BPD. Our study speculate that NO was related to BPD though Th2-cell-mediatedinflammatory responses such as IL-4. The cytokines may provide a certain predictive value for the occurrence of BPD.

scholarly journals The high-risk factors of different severities of bronchopulmonary dysplasia (BPD) based on the national institute of child health and human development (NICHD) diagnosis criteria in 2018

2021 ◽  
pp. e20210125
Author(s):  
Minqiao Jian1,2 ◽  
Shaoru He1,2 ◽  
Yumei Liu2 ◽  
Xiaoqing Liu3 ◽  
Juan Gui2 ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Ductus Arteriosus ◽  
Severe Illness ◽  
Pulmonary Infections ◽  
High Risk Factors ◽  
Severe Group

Objective: To investigate the clinical characteristics of preterm infants with different severities of bronchopulmonary dysplasia (BPD) and disclose the high-risk factors of exacerbating BPD. Methods: Collection of clinical data of 91 preterm infants admitted to the NICU and diagnosed with BPD, categorized in groups according to the disease severity: 41 mild cases,, 24 moderate cases, and 26 severe cases. Comparison and analysis of perinatal risk factors, treatment, complications and prognosis of the infants with different severity degrees. Results: The severe group had a higher proportion of infants with congenital heart disease (CHD) higher than the moderate group (P < 0.05), and a higher ratio of pneumonia and mechanical ventilation (MV) = seven days than the mild group (P < 0.05). The severe group also presented higher reintubation incidence than both the mild and moderate groups (P < 0.05). The groups presented different (P < 0.05) incidence rates of hemodynamically significant patent ductus arteriosus (hsPDA) . Ridit analysis suggested that the premature infants (PIs) with hsPDA, multiple microbial pulmonary infections, or Klebsiella pneumoniae pneumonia had more severe illness. Conclusion: CHD, hsPDA, MV = seven days, reintubation, pneumonia, especially multiple microbial pulmonary infections, and Klebsiella pneumoniae pneumonia are correlated with the severity of BPD and can be used as BPD progression predictor.

scholarly journals Prediction of COVID-19 Patients at High Risk of Progression to Severe Disease

2020 ◽  
Vol 8 ◽  
Author(s):  
Zhenyu Dai ◽  
Dong Zeng ◽  
Dawei Cui ◽  
Dawei Wang ◽  
Yanling Feng ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Disease Severity ◽  
Cox Regression ◽  
Clinical Chemistry ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Bootstrap Sampling ◽  
Orthogonal Projections ◽  
High Risk Factors

In order to develop a novel scoring model for the prediction of coronavirus disease-19 (COVID-19) patients at high risk of severe disease, we retrospectively studied 419 patients from five hospitals in Shanghai, Hubei, and Jiangsu Provinces from January 22 to March 30, 2020. Multivariate Cox regression and orthogonal projections to latent structures discriminant analysis (OPLS-DA) were both used to identify high-risk factors for disease severity in COVID-19 patients. The prediction model was developed based on four high-risk factors. Multivariate analysis showed that comorbidity [hazard ratio (HR) 3.17, 95% confidence interval (CI) 1.96–5.11], albumin (ALB) level (HR 3.67, 95% CI 1.91–7.02), C-reactive protein (CRP) level (HR 3.16, 95% CI 1.68–5.96), and age ≥60 years (HR 2.31, 95% CI 1.43–3.73) were independent risk factors for disease severity in COVID-19 patients. OPLS-DA identified that the top five influencing parameters for COVID-19 severity were CRP, ALB, age ≥60 years, comorbidity, and lactate dehydrogenase (LDH) level. When incorporating the above four factors, the nomogram had a good concordance index of 0.86 (95% CI 0.83–0.89) and had an optimal agreement between the predictive nomogram and the actual observation with a slope of 0.95 (R2 = 0.89) in the 7-day prediction and 0.96 (R2 = 0.92) in the 14-day prediction after 1,000 bootstrap sampling. The area under the receiver operating characteristic curve of the COVID-19-American Association for Clinical Chemistry (AACC) model was 0.85 (95% CI 0.81–0.90). According to the probability of severity, the model divided the patients into three groups: low risk, intermediate risk, and high risk. The COVID-19-AACC model is an effective method for clinicians to screen patients at high risk of severe disease.

scholarly journals An Important Finding of White Matter Injury in Late Preterm Infant: Deep Medullary Vein Involvement

2020 ◽  
Vol 8 ◽  
Author(s):  
Dan Chen ◽  
Jing Sun ◽  
Qiuyu Li ◽  
Wenjuan Bai ◽  
Jian Mao
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
High Risk ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Late Preterm ◽  
White Matter Injury ◽  
Late Preterm Infants ◽  
High Risk Factors ◽  
Mri Features

Objective: To investigate high risk factors and magnetic resonance imaging (MRI) features in late preterm infants with severe white matter injury (WMI) associated with abnormal deep medullary veins (DMVs).Materials and Methods: Preterm infants with severe WMI, who were hospitalized in Shengjing Hospital from 1st January 2009 to 31st December 2018, were enrolled in this retrospective study. High risk factors and MRI characteristics of infants with abnormal DMVs were analyzed and compared with those of infants without DMV abnormalities.Results: A total of 2032 late preterm infants were examined by MRI; 71 cases (3.5%) had severe WMI and 15 of these (21.1%) had abnormal DMVs. The incidence of maternal diabetes was higher in infants with abnormal DMVs and neonatal convulsions were more likely (P &lt; 0.05). The incidence of grade IV injury (P &lt; 0.05), white matter periventricular cysts and thalamic injury (P &lt; 0.01), cerebral venous sinus thrombus (P &lt; 0.01) and germinal matrix/intraventricular hemorrhage (P &lt; 0.05) were higher in infants with abnormal DMVs than in infants with normal DMVs.Conclusions: Congestion/thrombosis of DMVs may be an important cause of severe WMI in late preterm infants, especially in periventricular leukomalacia-like WMI. WMI with abnormal DMVs is more likely to lead to thalamic injury.

scholarly journals Association Between Blood Gas Within 1week of Life and Bronchopulmonary Dysplasia in Preterm Infants With Less Than 32 Gestational Weeks

2020 ◽  
Author(s):  
Xiaoya Han ◽  
Xiaolin Miao ◽  
Limin Guo ◽  
Na Li ◽  
Cun Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Clinical Characteristics ◽  
Independent Risk Factor ◽  
P Value ◽  
Blood Gas ◽  
Increased Risk ◽  
Close Relationship

Abstract Objective: This study tested wether preterm infants of ＜32 gestational weeks (GWs) with a blood gas derangement within 7days of life are at increased risk for moderate and severe bronchopulmonary dysplasia (BPD). Method: 236 preterm infants with ＜32 GWs from January of 2017 to December of 2019 were included in this study. First, univariate analysing determined wether there existed associations between BPD (moderate and severe) and blood gas values, clinical characteristics, interventions, daily given liquid and eneregy within 7days of life. Then multivarariate regession analysis was performed to know wether there were relationships between BPD (moderate and severe) and risk factors between which and BPD (moderate and severe) univariate analysing showed that P value was less than 0.1. Results: From univariate analysing, we found that PaO2, PaCO2 and HCO3 in 7th day of life, cesarean section (OR=0.508, 95%CI:0.275-0.94), getational age (GA, OR=0.163, 95%CI:0.077-0.344), birth weight (BW, OR=0.122, 95%CI:0.054-0.273), PDA (OR=2.839, 95%CI:1.1463-5.508), early onset infection (OR=3.00, 95%CI:1.483-6.069), and mechanical ventilation (MV, OR=4.562, 95%CI:2.405-8.653) were significantly associated with moderate and severe BPD. Because there existed close relationship between GA and BW (R=0.642, P=0.000) and BW dispersion was big in this group, we excluded BW in multivariate analysing. From multivariate analysing, besides GA (Exp (B)=0.176, 95%CI:0.08-0.389) , MV (Exp (B)=3.515, 95%CI:1.746-7.076), PaO2 (Exp (B)=0.468, 95%CI:0.226-0.969) in 7th day of life was the independent risk factor for moderate and severe BPD in the preterm infants of ＜32 GWs.Conclusion: Preterm infants of ＜32GWs with blood gas derangements within 7days of life could be at risk of moderate and severe BPD.

High risk factors for fetal development

2020 ◽  
pp. 59-65
Author(s):  
Z.V. Sirotina ◽  
◽  
V.N. Sokolov ◽  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Fetal Development ◽  
High Risk Factors

scholarly journals Screening strategy and time points for newborn hearing re-screening with high risk factors

2021 ◽  
Author(s):  
Qingxiang Zeng ◽  
Renzhong Luo ◽  
Shengbao Yan ◽  
Yiquan Tang ◽  
Ruijin Wen ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Screening Strategy ◽  
Time Points ◽  
High Risk Factors ◽  
Newborn Hearing
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