bronchopulmonary dysplasia
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Author(s):  
Samuel J. Gentle ◽  
Benjamin Carper ◽  
Matthew M. Laughon ◽  
Erik A. Jensen ◽  
Austin Williams ◽  
...  

2022 ◽  
Author(s):  
Stephanie A. Adaikalam ◽  
Nara S. Higano ◽  
Erik B. Hysinger ◽  
Alister J. Bates ◽  
Robert J. Fleck ◽  
...  

Author(s):  
Brittany Ann Ruschkowski ◽  
Yousef Esmaeil ◽  
Kate Daniel ◽  
Chantal Gaudet ◽  
Behzad Yeganeh ◽  
...  

Author(s):  
Anouk Pels ◽  
Wes Onland ◽  
Rolf M. F. Berger ◽  
Arno F. J. van Heijst ◽  
Enrico Lopriore ◽  
...  

AbstractThe aim was to reflect on the unexpected finding of persistent pulmonary hypertension of the neonate (PPHN) and pulmonary hypertension in infants born within the Dutch STRIDER trial, its definition and possible pathophysiological mechanisms. The trial randomly assigned pregnant women with severe early-onset fetal growth restriction to sildenafil 25 mg three times a day versus placebo. Sildenafil use did not reduce perinatal mortality and morbidity, but did result in a higher rate of neonatal pulmonary hypertension (PH). The current paper reflects on the used definition, prevalence, and possible pathophysiology of the data on pulmonary hypertension. Twenty infants were diagnosed with pulmonary hypertension (12% of 163 live born infants). Of these, 16 infants had PPHN shortly after birth, and four had pulmonary hypertension associated with sepsis or bronchopulmonary dysplasia. Four infants with PPHN in the early neonatal period subsequently developed pulmonary hypertension associated with bronchopulmonary dysplasia in later life. Infants with pulmonary hypertension were at lower gestational age at delivery, had a lower birth weight and a higher rate of neonatal co-morbidity. The infants in the sildenafil group showed a significant increase in pulmonary hypertension compared to the placebo group (relative risk 3.67; 95% confidence interval 1.28 to 10.51, P = 0.02).Conclusion: Pulmonary hypertension occurred more frequent among infants of mothers allocated to antenatal sildenafil compared with placebo. A possible pathophysiological mechanism could be a “rebound” vasoconstriction after cessation of sildenafil. Additional studies and data are necessary to understand the mechanism of action. What is Known:• In the Dutch STRIDER trial, persistent pulmonary hypertension in the neonate (PPHN) was more frequent among infants after antenatal sildenafil exposure versus placebo. What is New:• The current analysis focuses on the distinction between PPHN and pulmonary hypertension associated with sepsis or bronchopulmonary dysplasia and on timing of diagnosis and aims to identify the infants at risk for developing pulmonary hypertension.• The diagnosis pulmonary hypertension is complex, especially in infants born after severe early-onset fetal growth restriction. The research field could benefit from an unambiguous consensus definition and standardized screening in infants at risk is proposed.


2022 ◽  
Author(s):  
Yanping Xu ◽  
Yeqing Huang ◽  
Zhen Shen ◽  
Liping Shi

Abstract Bronchopulmonary dysplasia (BPD) is chronic lung disease of prematurity and associated with substantial long-term disabilities. To characterize and compare the nasal swabs microbiome of early stage in premature infants and determine whether microbial diversity or composition in the airway associated with BPD disease. We performed a prospective observational cohort design. Preterm neonates less than 32 weeks of gestation were recruited from NICU, Children's Hospital, Zhejiang University School of Medicine from 2019 to 2020. Sterile foam swabs were collected from anterior nares at 1 and 3 weeks of postnatal age. We used PCR amplification and 16S rDNA sequencing. Neonatal demographic data including gestational age, birth weight, medication administration history were recorded. A total of 98 nasal swabs samples were collected from 54 preterm infants, 13 developed BPD infants and 41 control infants were finally involved in the study. Birth weights ranged from 700 to 2,050 g. Gestational age ranged from 25 2/7to 31 6/7. We found increased in the expression of Prevotella, Marinomonas, Enterobacteriaceae, Weissella, Selenomonas, Oribacterium, Nubsella and Antricoccus in BPD group at two time points. Prevotella was correlated with the severity of BPD (Spearman r=0.361, P=0.000). Given possible roles for noninvasive upper airway microbiota in BPD pathobiology, the nasal microbiome in BPD is a compelling area of research to continue to expand.


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