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Published on: May 4, 2020
Umbilical Cord-Derived Cell-Based Interventions for Bronchopulmonary Dysplasia and Related Complications in Preterm
Yonghao Wen1,2, Yunlong Duan1,2, Ru Nie2
1Stem Cell and Regenerative Medicine Laboratory, Affiliated Hospital of Qinghai University, Xining, China.
Insights
Umbilical cord-derived cell therapies may reduce moderate or severe bronchopulmonary dysplasia (BPD) in preterm infants. While promising for BPD and retinopathy of prematurity (ROP), evidence is limited, necessitating larger trials.
Area of Science:
- Neonatal Medicine
- Regenerative Medicine
- Systematic Review and Meta-Analysis
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication of prematurity with few effective treatments.
- Preterm infants are at high risk for BPD and its associated morbidities.
- Umbilical cord-derived cell-based interventions are being explored as potential therapies.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of umbilical cord-derived cell interventions for BPD in preterm infants.
- To assess the impact of these interventions on BPD severity, mortality, and other neonatal complications.
- To evaluate the safety profile of umbilical cord-derived cell-based therapies.
Main Methods:
- A systematic review and meta-analysis following PRISMA 2020 guidelines.
- Searched multiple databases (PubMed, Cochrane Library, Web of Science, CNKI, Wanfang) up to June 14, 2026.
- Included comparative clinical studies of umbilical cord-derived cell interventions in preterm infants.
- Bayesian random-effects meta-analysis was employed to estimate pooled odds ratios and credible intervals.
Main Results:
- A potential protective effect was observed for overall BPD (OR, 0.48; 95% CrI, 0.14-1.20).
- Significant associations were found for reducing severe BPD (OR, 0.17; 95% CrI, 0.01-0.85) and moderate or severe BPD (OR, 0.28; 95% CrI, 0.09-0.70).
- A potential benefit was noted for retinopathy of prematurity (ROP) stage ≥3 (OR, 0.17; 95% CrI, 0.02-0.65).
- No conclusive benefits or harms were identified for mortality, PPHN, PDA, IVH, NEC, or LOS.
- No serious treatment-related adverse events were reported, but evidence certainty was low to very low.
Conclusions:
- Umbilical cord-derived cell-based interventions may decrease the risk of moderate to severe BPD in preterm infants.
- These therapies might also offer benefits for ROP stage ≥3.
- Larger, high-quality randomized trials with standardized outcomes and long-term follow-up are essential to confirm these findings.
Abstract:
Bronchopulmonary dysplasia (BPD) is a major complication of prematurity with limited disease-modifying therapies. We evaluated umbilical cord-derived cell-based interventions for BPD and related complications in preterm infants. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-based systematic review and meta-analysis were registered in PROSPERO. PubMed, Cochrane Library, Web of Science, CNKI, and Wanfang were searched from inception to June 14, 2026. Comparative clinical studies of umbilical cord-derived cell-based interventions in preterm infants at risk of or diagnosed with BPD were included. Outcomes included BPD, BPD severity, death, persistent pulmonary hypertension of the newborn (PPHN), patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), late-onset sepsis (LOS), and adverse events (AEs). Bayesian random-effects meta-analysis used a binomial-normal hierarchical model to estimate pooled odds ratios (ORs), 95% credible intervals (CrIs), prediction intervals, and heterogeneity. Twelve studies were included. Umbilical cord-derived cell-based interventions showed a possible protective effect on overall BPD (OR, 0.48; 95% CrI, 0.14-1.20). Stronger associations were observed for severe BPD (OR, 0.17; 95% CrI, 0.01-0.85), moderate or severe BPD (OR, 0.28; 95% CrI, 0.09-0.70), and ROP stage ≥3 (OR, 0.17; 95% CrI, 0.02-0.65). No conclusive benefit or harm was observed for death, PPHN, PDA, IVH, NEC, or LOS. No treatment-related serious AEs were identified. However, prediction intervals were generally wide, and the certainty of evidence was low to very low for most outcomes. Umbilical cord-derived cell-based interventions may reduce the risk of moderate or severe BPD in preterm infants, with an additional potential benefit for ROP stage ≥3. Current evidence remains limited, and larger randomized trials with standardized outcomes and long-term follow-up are needed.
