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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Hematological parameters of bronchopulmonary dysplasia in preterm infants: a meta-analysis
Hongyu Li1,2, Jia Fan3, Hehua Du1,2
1Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
This systematic review found significant differences in neutrophil, hemoglobin, hematocrit, and platelet counts between infants with and without bronchopulmonary dysplasia (BPD). However, key hematological parameters like HCT, PLT, and HGB were not significant independent risk factors for BPD.
Area of Science:
- Neonatal Medicine
- Pulmonology
- Hematology
Background:
- Bronchopulmonary dysplasia (BPD) is a severe chronic lung disease in preterm infants.
- Existing research on hematological parameters (HPs) and BPD shows inconsistent findings.
Purpose of the Study:
- To systematically review and meta-analyze the association between HPs and BPD in preterm infants.
- To clarify the role of HPs in BPD development and their potential as diagnostic markers.
Main Methods:
- Systematic review and meta-analysis of 20 studies (4,752 participants) from major databases.
- Adherence to PRISMA guidelines and quality assessment using the Newcastle-Ottawa Scale.
- Statistical analysis using Stata 18 and MetaDisc.
Main Results:
- Significant differences observed in neutrophil (NEU), hemoglobin (HGB), hematocrit (HCT), red blood cell (RBC), platelet (PLT) counts, neutrophil-to-lymphocyte ratio (NLR), and systemic inflammatory response index (SIRI) between BPD and non-BPD infants.
- Elevated NEU, NLR, and SIRI, with reduced HGB, HCT, RBC, and PLT in BPD infants.
- HCT, PLT, and HGB were not statistically significant independent risk factors for BPD; NLR and PLT showed limited diagnostic ability (ROC-AUC ~0.67).
Conclusions:
- While certain HPs differ significantly between BPD and non-BPD infants, key parameters like HCT, PLT, and HGB may not be independent risk factors.
- Further large-scale, multicenter prospective studies are needed to confirm these findings and explore diagnostic potential.
Background:
Bronchopulmonary dysplasia (BPD) represents the most widespread and severe form of chronic pulmonary disease in preterm infants. Studies have revealed an association between BPD and hematological parameters (HPs); however, the findings are inconsistent.
Objectives:
This study utilized a systematic review and meta-analysis to summarize the association.
Methods:
The Web of Science, Cochrane Library, Embase, and PubMed were retrieved up to May 4, 2024, with an update on April 10, 2025. Studies investigating the correlation between HPs and BPD in preterm infants were included. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the studies was evaluated via the Newcastle-Ottawa Scale. Stata 18 and MetaDisc were utilized for statistical analysis.
Results:
This meta-analysis encompassed 20 studies with a total of 4,752 participants and investigated the association between HPs and BPD in neonates. Statistically significant differences were found between BPD and non-BPD infants for eight parameters: neutrophil (NEU) count, hemoglobin (HGB), monocyte count, hematocrit (HCT), neutrophil-to-lymphocyte ratio (NLR), red blood cell (RBC) count, platelet (PLT) count, and systemic inflammatory response index (SIRI). Further correlation analysis and effect size evaluation revealed that, while some parameters differed between groups, the association between key parameters and BPD risk was not significant. Specifically, the odds ratios (ORs) for HCT (OR = 1.33, 95% confidence interval [CI]: -0.11 to 2.77), PLT (OR = 1.0, 95% CI: 0.98-1.03), and HGB (OR = 1.38, 95% CI: 0.42-4.49) did not reach statistical significance, suggesting these three parameters may not be independent influencing factors for BPD risk. Concurrently, diagnostic performance analysis demonstrated limited discriminatory ability for NLR, with a receiver operating characteristic-area under the curve (ROC-AUC) of 0.670 (standard error [SE] = 0.054), and for PLT, with an ROC-AUC of 0.675 (SE = 0.067).
Conclusions:
The current study indicated significant differences in NEU, HGB, HCT, RBC, PLT, NLR, and SIRI between BPD and non-BPD patients, with elevated NEU, NLR, and SIRI and reduced HGB, HCT, RBC, and PLT. However, this study had its limitations. Further analysis requires more multicenter, large-sample prospective studies.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024552716.
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