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A Time-Based Analysis of Inflammation in Infants at Risk of Bronchopulmonary Dysplasia

Sandrine Leroy1, Elsa Caumette2, Chandra Waddington3

  • 1EA2415, Montpellier University, Montpellier, France; Mobile Pediatrics Intensive Care Unit, Avicenne hospital, AP-HP, Paris, France.

The Journal of Pediatrics
|November 3, 2017
PubMed

Insights

Systemic inflammation early in preterm infants predicts bronchopulmonary dysplasia (BPD). This inflammation precedes clinical symptoms, suggesting a critical window for interventions in neonatal intensive care.

Area of Science:

  • Neonatology
  • Immunology
  • Pediatric Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
  • The role of early neonatal inflammation in BPD development requires precise delineation.

Purpose of the Study:

  • To precisely determine the timing and contribution of systemic inflammation to BPD in preterm infants during the neonatal period.

Main Methods:

  • Longitudinal study of blood inflammatory biomarkers (IL-6, IL-8, G-CSF) from birth to 42 days in infants <30 weeks gestation.
  • Hierarchical mixed-effects regression models adjusted for infant-specific and time-dependent factors.

Main Results:

  • Infants who developed BPD showed increased inflammation post-birth compared to controls.
  • Sustained inflammation, particularly IL-8 and G-CSF, predicted BPD and was higher in boys and lower birth weight infants.
  • Inflammation preceded clinical BPD signs, increased oxygen needs, and neonatal sepsis or necrotizing enterocolitis.

Conclusions:

  • Early systemic inflammation in the neonatal period precedes BPD clinical symptoms.
  • Identified a vulnerability window, supporting early, targeted intensive care interventions for BPD prevention.
Abstract

Keywords:
bronchopulmonary dysplasiacytokineinflammationpremature infantrisk period

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