scholarly journals Prediction Model for Bronchopulmonary Dysplasia in Preterm Newborns

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 886
Author(s):  
Joanna Maria Jassem-Bobowicz ◽  
Dagmara Klasa-Mazurkiewicz ◽  
Anton Żawrocki ◽  
Katarzyna Stefańska ◽  
Iwona Domżalska-Popadiuk ◽  
...  
Keyword(s):  
Predictive Model ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Characteristic Curve ◽  
Ductus Arteriosus ◽  
Significant Risk ◽  
Area Under The Curve ◽  
Multifactorial Model ◽  
Model Based ◽  
Preterm Newborns

OBJECTIVE: To develop a multifactorial model that allows the prediction of bronchopulmonary dysplasia (BPD) in preterm newborns. MATERIALS AND METHODS: A single-center retrospective study of infants born below 32 + 0 weeks gestational age. We created a receiver operating characteristic curve to assess the multifactorial BPD risk and calculated the BPD risk accuracy using the area under the curve (AUC). The BPD risk was categorized using a multifactorial predictive model based on the weight of the evidence. RESULTS: Of the 278 analyzed preterm newborns, 127 (46%) developed BPD. The significant risk factors for BPD in the multivariate analysis were gestational age, number of red blood cell concentrate transfusions, number of surfactant administrations, and hemodynamically significant patent ductus arteriosus. The combination of these factors determined the risk of developing BPD, with an AUC value of 0.932. A multifactorial predictive model based on these factors, weighted by their odds ratios, identified four categories of newborns with mean BPD risks of 9%, 59%, 82%, and 100%. CONCLUSION: A multifactorial model based on easily available clinical factors can predict BPD risk in preterm newborns and inform potential preventive measures.

Gestational Age Dependency of Umbilical Cord Serum IL-6 Levels for Detecting Fetal Inflammation

2020 ◽  
Author(s):  
Sota Iwatani ◽  
Takao Kobayashi ◽  
Sachiko Matsui ◽  
Akihiro Hirata ◽  
Miwa Yamamoto ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Cord Serum ◽  
Very Preterm ◽  
Key Points ◽  
Extremely Preterm ◽  
Preterm Newborns

Objective The fetal inflammatory response syndrome (FIRS) is characterized by elevated concentrations of inflammatory cytokines in fetal blood, with preterm delivery and morbidity. Umbilical cord serum interleukin-6 (UC-s-IL-6) is an ideal marker for detecting FIRS. However, the effect of gestational age (GA) on UC-s-IL-6 levels has not been reported. This study aimed to determine the relationship between GA and UC-s-IL-6 levels, and GA-dependent cutoff values of UC-s-IL-6 levels for detecting fetal inflammation. Study Design UC-s-IL-6 concentrations were measured in 194 newborns (44 extremely preterm newborns (EPNs) at 22–27 weeks' GA, 68 very preterm newborns (VPNs) at 28–31 weeks' GA, and 82 preterm newborns (PNs) at 32–34 weeks' GA). Linear regression analyses were used to correlate GA and UC-s-IL-6 levels. Receiver operating characteristic (ROC) curves analyses were performed for detecting the presence of funisitis, as the histopathological counterpart of FIRS. Results A significant negative correlation between GA and UC-s-IL-6 levels was found in newborns with severe funisitis (r s =  − 0.427, p = 0.004) and those with mild funisitis (r s =  − 0.396, p = 0.025). ROC curve analyses revealed the area under the curve for detecting funisitis were 0.856, 0.837, and 0.622 in EPNs, VPNs, and PNs, respectively. The UC-s-IL-6 cutoff value in EPNs (28.1 pg/mL) exceeded those in VPNs and PNs (3.7 and 3.0 pg/mL, respectively). Conclusion UC-s-IL-6 levels were inversely correlated with GA especially in newborns with funisitis. Such GA dependency of UC-s-IL-6 should be considered for detecting fetal inflammation. Key Points

scholarly journals Red cell distribution width as a predictor for bronchopulmonary dysplasia in premature infants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hayato Go ◽  
Hitoshi Ohto ◽  
Kenneth E. Nollet ◽  
Kenichi Sato ◽  
Hirotaka Ichikawa ◽  
...  
Keyword(s):  
Blood Cell ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Red Blood Cell ◽  
Area Under The Curve ◽  
Cell Distribution ◽  
Characteristic Analysis ◽  
Distribution Width ◽  
Potential Biomarker ◽  
Rbc Transfusion

AbstractBronchopulmonary dysplasia (BPD) is the most common morbidity complicating preterm birth. Red blood cell distribution width (RDW), a measure of the variation red blood cell size, could reflect oxidative stress and chronic inflammation in many diseases such as cardiovascular, pulmonary, and other diseases. The objectives of the present study were to evaluate perinatal factors affecting RDW and to validate whether RDW could be a potential biomarker for BPD. A total of 176 preterm infants born at < 30 weeks were included in this study. They were categorized into BPD (n = 85) and non-BPD (n = 91) infants. RDW at birth and 14 days and 28 days of life (DOL 14, DOL 28) were measured. Clinical data were obtained from all subjects at Fukushima Medical University (Fukushima, Japan). The mean RDW at birth, DOL 14 and DOL 28 were 16.1%, 18.6%, 20.1%, respectively. Small for gestational age (SGA), chorioamnionitis (CAM), hypertensive disorders of pregnancy (HDP), gestational age and birth weight were significantly associated with RDW at birth. SGA, BPD and red blood cell (RBC) transfusion before DOL 14 were associated with RDW at DOL 14. BPD and RBC transfusion before DOL 14 were associated with RDW at DOL 28. Compared with non-BPD infants, mean RDW at birth DOL 14 (21.1% vs. 17.6%, P < 0.001) and DOL 28 (22.2% vs. 18.2%, P < 0.001) were significantly higher in BPD infants. Multivariate analysis revealed that RDW at DOL 28 was significantly higher in BPD infants (P = 0.001, odds ratio 1.63; 95% CI 1.22–2.19). Receiver operating characteristic analysis for RDW at DOL 28 in infants with and without BPD yielded an area under the curve of 0.87 (95% CI 0.78–0.91, P < 0.001). RDW at DOL 28 with mild BPD (18.3% vs. 21.2%, P < 0.001), moderate BPD (18.3% vs. 21.2%, P < 0.001), and severe BPD (18.3% vs. 23.9%, P < 0.001) were significantly higher than those with non-BPD, respectively. Furthermore, there are significant differences of RDW at DOL 28 between mild, moderate, and severe BPD. In summary, we conclude that RDW at DOL 28 could serve as a biomarker for predicting BPD and its severity. The mechanism by which RDW at DOL 28 is associated with the pathogenesis of BPD needs further elucidation.

scholarly journals Immune profiling of plasma-derived extracellular vesicles identifies Parkinson disease

2020 ◽  
Vol 7 (6) ◽  
pp. e866 ◽  
Author(s):  
Elena Vacchi ◽  
Jacopo Burrello ◽  
Dario Di Silvestre ◽  
Alessio Burrello ◽  
Sara Bolis ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Machine Learning Algorithms ◽  
Supervised Machine Learning ◽  
Diagnostic Model ◽  
Surface Markers ◽  
Model Based ◽  
Immune Profiling

ObjectiveTo develop a diagnostic model based on plasma-derived extracellular vesicle (EV) subpopulations in Parkinson disease (PD) and atypical parkinsonism (AP), we applied an innovative flow cytometric multiplex bead-based platform.MethodsPlasma-derived EVs were isolated from PD, matched healthy controls, multiple system atrophy (MSA), and AP with tauopathies (AP-Tau). The expression levels of 37 EV surface markers were measured by flow cytometry and correlated with clinical scales. A diagnostic model based on EV surface markers expression was built via supervised machine learning algorithms and validated in an external cohort.ResultsDistinctive pools of EV surface markers related to inflammatory and immune cells stratified patients according to the clinical diagnosis. PD and MSA displayed a greater pool of overexpressed immune markers, suggesting a different immune dysregulation in PD and MSA vs AP-Tau. The receiver operating characteristic curve analysis of a compound EV marker showed optimal diagnostic performance for PD (area under the curve [AUC] 0.908; sensitivity 96.3%, specificity 78.9%) and MSA (AUC 0.974; sensitivity 100%, specificity 94.7%) and good accuracy for AP-Tau (AUC 0.718; sensitivity 77.8%, specificity 89.5%). A diagnostic model based on EV marker expression correctly classified 88.9% of patients with reliable diagnostic performance after internal and external validations.ConclusionsImmune profiling of plasmatic EVs represents a crucial step toward the identification of biomarkers of disease for PD and AP.

9 The Burden of Bronchopulmonary Dysplasia and Pulmonary Vascular Disease in Premature Infants

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e7-e7
Author(s):  
Gabriela de Carvalho Nunes ◽  
Punnanee Wutthigate ◽  
Jessica Simoneau ◽  
Claudia Renaud ◽  
Adrian Dancea ◽  
...  
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Gestational Age ◽  
Ductus Arteriosus ◽  
Positive Pressure ◽  
Pulmonary Vascular Disease ◽  
Intervention Policy ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Extremely premature infants are at a high risk of bronchopulmonary dysplasia (BPD) and BPD-associated pulmonary hypertension (PH). Prolonged patency of the ductus arteriosus (PDA) may worsen PH; however, due to the lack of evidence supporting improvement in outcomes after strategies to promote ductal closure, our center has adopted a strict non-intervention policy since 2013. Objectives Assess PH prevalence and severity, as well as the impact of BPD on echocardiographic parameters of cardiac performance. Design/Methods Retrospective cohort of infants &lt;29 weeks gestational age at birth, admitted between 2015 and 2019, and without genetic/congenital anomalies. Measurements from the echocardiography acquired closest to 36 weeks were done by masked experts. Severe BPD was defined as positive pressure support at 36 weeks. PH was defined as an estimated systolic pulmonary pressure (SPAP) ≥40 mmHg or an abnormal septal curvature by eccentricity index (EI) (&gt;1.3). Results Out of 387 infants, 222 were included, of which 27 (12%) were categorized as severe BPD and 78 (35%) had PH. Severe BPD was associated with lower birth weight (704±214 vs 842±229g, p&lt;0.01), longer hospitalization (median 138 [IQR 108-167] vs 103 [IQR 86-125] days, p&lt;0.01) and longer mechanical ventilation duration (median 82 [IQR 33-107] vs 17 [IQR 2-32] days, p&lt;0.01), with no difference in gestational age at birth. Severe BPD was associated with PH (70% vs 43%, p&lt;0.01). The combined outcome of death (after the 36 weeks echocardiography) or severe BPD was associated with PH (68% vs 30%, p&lt;0.01), smaller left ventricle length in diastole (2.8±0.5 vs 3.0±0.5 cm, p=0.03), decrease in the tricuspid annular plane systolic excursion (0.7±0.2 vs 0.9±0.2 cm, p&lt;0.01), abnormal EI (1.31±0.25 vs 1.17±0.18, p&lt;0.01) and smaller right ventricle fraction area change (41.3±5.8 vs 47.8±7.6%, p&lt;0.01), without a significant increase on SPAP (35±21 vs 35±14, p=0.15). Other echocardiographic markers were similar. Conclusion In the context of a PDA non-intervention policy, a third of our population was affected by PH at 36 weeks. Furthermore, those with severe BPD or death had signs of RV dysfunction (despite similar SPAP estimate), indicating that the effect of BPD on pulmonary vascular remodelling and cardiac function may be underestimated.

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 Bronchopulmonary Dysplasia Predicted by Developing a Machine Learning Model of Genetic and Clinical Information

2021 ◽  
Vol 12 ◽  
Author(s):  
Dan Dai ◽  
Huiyao Chen ◽  
Xinran Dong ◽  
Jinglong Chen ◽  
Mei Mei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Model ◽  
Risk Prediction ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Genetic Factors ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Clinical Risk Factors ◽  
Clinical Risk

BackgroundAn early and accurate evaluation of the risk of bronchopulmonary dysplasia (BPD) in premature infants is pivotal in implementing preventive strategies. The risk prediction models nowadays for BPD risk that included only clinical factors but without genetic factors are either too complex without practicability or provide poor-to-moderate discrimination. We aim to identify the role of genetic factors in BPD risk prediction early and accurately.MethodsExome sequencing was performed in a cohort of 245 premature infants (gestational age &lt;32 weeks), with 131 BPD infants and 114 infants without BPD as controls. A gene burden test was performed to find risk genes with loss-of-function mutations or missense mutations over-represented in BPD and severe BPD (sBPD) patients, with risk gene sets (RGS) defined as BPD–RGS and sBPD–RGS, respectively. We then developed two predictive models for the risk of BPD and sBPD by integrating patient clinical and genetic features. The performance of the models was evaluated using the area under the receiver operating characteristic curve (AUROC).ResultsThirty and 21 genes were included in BPD–RGS and sBPD–RGS, respectively. The predictive model for BPD, which combined the BPD–RGS and basic clinical risk factors, showed better discrimination than the model that was only based on basic clinical features (AUROC, 0.915 vs. AUROC, 0.814, P = 0.013, respectively) in the independent testing dataset. The same was observed in the predictive model for sBPD (AUROC, 0.907 vs. AUROC, 0.826; P = 0.016).ConclusionThis study suggests that genetic information contributes to susceptibility to BPD. The predictive model in this study, which combined BPD–RGS with basic clinical risk factors, can thus accurately stratify BPD risk in premature infants.

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 Three-Dimensional Length from the Center of the Liver is a Prognostic Factor of Colorectal Cancer with Liver Metastasis: A Retrospective Analysis

2020 ◽  
Author(s):  
Jun Woo Bong ◽  
Yeonuk Ju ◽  
Jihyun Seo ◽  
Sang Hee Kang ◽  
Pyoung-Jae Park ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Overall Survival ◽  
Liver Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Resection Margin ◽  
Characteristic Curve ◽  
Significant Risk ◽  
Area Under The Curve ◽  
Positive Resection Margin

Abstract Background Resectability of liver metastasis is important to establish a treatment strategy for colorectal cancer patients. We aimed to evaluate the effect of distance from metastasis to the center of the liver on the resectability and patient outcomes after hepatectomy. Methods Clinical data of a total of 124 patients who underwent hepatectomy for colorectal cancer with liver metastasis were retrospectively reviewed. We measured the minimal length from metastasis to the bifurcation of the portal vein at the primary branch of the Glissonean tree and defined it as “Centrality”. Predictive effects on positive resection margin and overall survival of centrality were statistically analyzed. Results The value as a predictive factor for the positive resection margin of centrality was analyzed by the receiver operating characteristic curve (area under the curve = 0.72, P<0.001). In multivariate analysis, total number of metastases ≥ 3 and centrality ≤ 1.5 cm were significant risk factors of overall survival. Patients with these two risk factors (n=21) had worse 5-year overall survival (10.7%) than patients with one (n=35, 58.3%) or no risk factor (n=68, 69.2%). In subgroups analysis, neoadjuvant chemotherapy improved overall survival in patients with these two risk factors. Conclusion Centrality was related with a positive resection margin and had a negative effect on survival. By combining the total number of metastases with centrality, we could determine disease prognosis and neoadjuvant chemotherapy indications for advanced colorectal cancer with liver metastasis.

scholarly journals Information value of ante- and intranatal risk factors for bronchopulmonary dysplasia in preterm newborns

2019 ◽  
Vol 64 (3) ◽  
pp. 60-67
Author(s):  
N. M. Agarkov ◽  
D. I. Kicha ◽  
Yu. Yu. Blinkov ◽  
V. N. Antsupov ◽  
R. V. Protsenko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Information Value ◽  
Control Group ◽  
Intrauterine Growth ◽  
Threatened Miscarriage ◽  
Acute Respiratory Viral Infection ◽  
Preterm Newborns

Aim of the study. To identify the leading antenatal and intranatal risk factors for bronchopulmonary dysplasia based on the analysis of their prevalence and information content Materials and methods. We performed a prospective follow-up of 124 infants of gestational age of less than 32 weeks with the classical form of bronchopulmonary dysplasia (study group). The control group included 119 newborns with gestational age of less than 32 weeks without bronchopulmonary dysplasia. The parents of the compared groups were questioned, with the following assessment of the prevalence and informative value of antenatal and intranatal risk factors. Results. The leading antenatal and intranatal risk factors for the development of bronchopulmonary dysplasia are: acute respiratory viral infection in II-III trimester, threatened miscarriage, intrauterine growth retardation, Apgar score at the 1st (3 or less) and 5th minute (5 or less), body weight of less than 1400g at birth, body length less than 36 cm at birth, cesarean section, more then 6-hours waterless period. Conclusion. The  combination of  these intranatal and antenatal risk factors can be attributed to a group with high risk of bronchopulmonary dysplasia.

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