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Predicting the likelihood of bronchopulmonary dysplasia in premature neonates
Patrick A Philpot1, Vineet Bhandari2
1Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Thomas Jefferson University College of Medicine, Nemours/Alfred I. DuPont Hospital for Children , Philadelphia , PA , USA.
Insights
Predicting bronchopulmonary dysplasia (BPD) in premature infants is challenging. New models integrating clinical data, biomarkers, and omics technologies show promise for improved early risk prediction of BPD.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Biomarker Discovery
Background:
- Bronchopulmonary dysplasia (BPD) is a common, serious lung condition in premature infants.
- Despite advances in neonatal care, BPD incidence remains unchanged, highlighting prediction challenges.
- Current therapeutic options for BPD are limited, emphasizing the need for early risk identification.
Purpose of the Study:
- To review current risk factors and biomarkers for predicting BPD in preterm neonates.
- To evaluate the efficacy of existing BPD prediction models.
- To propose strategies for enhancing future BPD prediction models.
Main Methods:
- Literature search focusing on the last five years of data.
- Analysis of risk factors from clinical data, biological fluid biomarkers, and respiratory management.
- Inclusion of 'omics' technologies for predicting BPD pathogenesis.
Main Results:
- Accurate BPD prediction requires multifactorial risk assessment.
- Existing predictive models often lack sufficient validation across diverse populations.
- Integrating various data categories is crucial for robust prediction.
Conclusions:
- Enhanced BPD prediction models should incorporate multiple, easily measurable variables.
- Validation across heterogeneous populations is essential for clinical utility.
- Future models can be improved by combining diverse data sources and rigorous validation.
Abstract:
Introduction: Bronchopulmonary dysplasia (BPD) is the most common serious pulmonary morbidity in premature infants. Despite ongoing advances in neonatal care, the incidence of BPD has not improved. A potential explanation for this phenomenon is the limited ability for accurate early prediction of the risk of BPD. BPD continues to represent a therapeutic challenge and no single effective therapy exists for this condition. Areas covered: Here, we review risk factors of BPD derived from clinical data, biological fluid biomarkers, respiratory management data, and scientific advancements using 'omics' technologies, and their ability to predict the pathogenesis of BPD in preterm neonates. Risk factors and biomarkers were identified via literature search with a focus on the last 5 years of data. Expert opinion: The most accurate predictive tools utilize risk factors that encompass a variety of categories. Numerous predictive models have been proposed but suffer from a lack of adequate validation. An ideal model should include multiple, easily measurable variables validated across a heterogeneous population. In addition to evaluating recent BPD prediction models, we suggest approaches to enhance future models.
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