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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
Published on: October 31, 2025
[PREDICTOIN OF THE COURSE OF BRONCHOPULMONARY DYSPLASIA IN PRETERM CHILDREN UP TO 3 YEARS OF AGE]
Т Klymenko1, Yu Sorokolat2, О Karapetyan1
1Kharkiv Medical Academy of Postgraduate Education, 1Department of neonatology, Ukraine.
Insights
Bronchopulmonary dysplasia (BPD) in premature infants is linked to patent ductus arteriosus (PDA). This study developed predictive algorithms for BPD course up to age 3, aiding individualized infant care.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Medical Technology
Background:
- Modern neonatal care improves premature infant survival but increases bronchopulmonary dysplasia (BPD) incidence.
- Understanding BPD progression is crucial for optimizing long-term outcomes in preterm infants.
Purpose of the Study:
- To characterize the course of BPD in premature infants.
- To develop methods for predicting BPD severity up to 3 years of age.
- To identify factors influencing BPD progression.
Main Methods:
- Spearman's nonparametric correlation analysis to assess relationships between BPD severity and patent ductus arteriosus (PDA).
- Heterogeneous sequential Wald-Genkin procedure for developing predictive algorithms.
- Reliability testing of predictive algorithms across different age groups.
Main Results:
- A direct correlation was found between BPD severity at 6 months and surgical closure of hemodynamically significant PDA in neonates (k=0.19; p=0.022).
- BPD severity at 3 years correlated with hemodynamically insignificant PDA beyond the neonatal period (k=0.18; p=0.031).
- Developed algorithms demonstrated high accuracy (90.3%-94.3%) in predicting BPD severity at 6 months, 12 months, and 3 years.
Conclusions:
- Patent ductus arteriosus (PDA) is a significant factor aggravating BPD course in preterm infants.
- Predictive algorithms enable individualized follow-up and management strategies for preterm infants with BPD.
- Diagnostic scales with set thresholds facilitate personalized care for preterm infants, improving BPD management.
Abstract:
The introduction of modern technologies for nursing premature babies has led to an improvement in the survival of premature infants and, at the same time, to an increase in the incidence of bronchopulmonary dysplasia (BPD). Тhe aim of work - to determine the characteristics of the course of BPD in premature infants and to provide methods for predicting the course of BPD up to 3 years of age. Using Spearman's nonparametric correlation analysis, a direct correlation between the severity of BPD at 6 months of age and the surgical closure of the hemodynamically significant patent ductus arteriosus (PDA) in the neonatal period (k=0.19; p=0.022) and between the severity of BPD in age 3 years and the presence of hemodynamically insignificant PDA later than the neonatal period (k=0.18; p = 0.031). Using the heterogeneous sequential Wald-Genkin procedure, algorithms were developed for predicting the severity of BPD at the age of 6, 12 months, and 3 years. Testing the reliability of the algorithms showed that in each of the age groups the correct diagnoses were 94,3% - 91,5% - 90,3%, uncertain - 4,3% - 6,7% - 7,4%, and false - 1,4% - 1,8% - 2,3% of cases, respectively, with a 95 % level of reliability. PDA should be considered as a factor that can aggravate the course of BPD in preterm children at all stages of observation. Creating diagnostic scales with a set diagnostic threshold allows predicting the course of BPD taking into account the characteristics of each observed child, which contributes to the individualization of follow-up observation of preterm children.
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