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Urinary β2-microglobulin and bronchopulmonary dysplasia: Trends in preterm infants
Yoshio Shima1,2, Sakae Kumasaka2, Shigeru Nishimaki3
1Department of Neonatal Medicine, Nippon Medical School, Musashikosugi Hospital, Kanagawa, Japan.
Insights
Very preterm infants born small for gestational age (SGA) with bronchopulmonary dysplasia (BPD) show a different inflammatory response pattern compared to appropriate for gestational age (AGA) infants. Prenatal factors may increase vulnerability in SGA infants with BPD.
Area of Science:
- Neonatalogy
- Pediatric Pulmonology
- Inflammatory Biomarkers
Background:
- Bronchopulmonary dysplasia (BPD) development differs between very preterm infants born small for gestational age (SGA) and appropriate for gestational age (AGA).
- Urinary β2-microglobulin (Uβ2M) serves as a concise, less-invasive biomarker for assessing inflammatory responses.
Purpose of the Study:
- To compare the inflammatory response patterns in very preterm infants with BPD, differentiating between SGA and AGA groups.
- To investigate the utility of Uβ2M as a biomarker in these distinct infant populations.
Main Methods:
- A cohort of 146 very preterm infants was studied.
- Urinary β2-microglobulin (Uβ2M) levels and clinical data were collected at birth and at 4 weeks of age.
- Infants were categorized into SGA and AGA groups, with BPD diagnosis considered.
Main Results:
- Among 57 infants with BPD, 18 were SGA and 39 were AGA.
- SGA infants with BPD had lower Uβ2M at birth compared to AGA infants with BPD, with levels increasing over time.
- Chorioamnionitis (CAM) prevalence was lower in SGA BPD infants, while pregnancy-induced hypertension was higher.
Conclusions:
- Prenatal factors beyond CAM may predispose very preterm SGA infants to lung inflammation and BPD.
- Distinct prenatal exposures contribute to differing inflammatory responses and BPD development in SGA versus AGA very preterm infants.
Background:
The developmental process of bronchopulmonary dysplasia (BPD) is not identical between very preterm infants born small for gestational age (SGA) and those born appropriate for gestational age (AGA). In this study, we compared the pattern of the inflammatory response in infants of each group, by measuring urinary β2-microglobulin (Uβ2M) as an alternative, concise, and less-invasive biomarker.
Methods:
Uβ2M and clinical details were examined at birth and at 4 weeks of age in 146 very preterm infants.
Results:
Of the 57 infants diagnosed with BPD, 18 were SGA, and 39 were AGA. Uβ2M at birth was significantly lower in SGA BPD infants than in AGA BPD infants, but it increased with time. The prevalence of chorioamnionitis (CAM) was significantly lower in SGA BPD infants than in AGA BPD infants, while that of pregnancy-induced hypertension was the opposite.
Conclusions:
Exposure to prenatal factors other than CAM may sensitize fetal lungs to become vulnerable to postnatal inflammation in very preterm SGA infants with BPD.
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