Neonatology Pub Date : 2025-03-06 DOI: 10.1159/000545106

Sreeja Kothapally, Chandra Rath, Bhanu B Gowda, Jay Sharma, Sanjay K Patole, Shripada Rao

{"title":"Early postnatal weight loss and its association with outcomes in very preterm neonates: a systematic review and meta-analysis.","authors":"Sreeja Kothapally, Chandra Rath, Bhanu B Gowda, Jay Sharma, Sanjay K Patole, Shripada Rao","doi":"10.1159/000545106","DOIUrl":"https://doi.org/10.1159/000545106","url":null,"abstract":"Introduction: Ideal early postnatal weight loss (PWL) and its association with mortality and morbidity in preterm infants is not well known. This review explored the association between early PWL and outcomes in very premature infants (<32 weeks).Methods: This is a systematic review and meta-analyses of the observational studies. PubMed, Medline, EMBASE, Cochrane Library, EMCARE and MedNar databases were searched in April 2024. Outcomes of interest were mortality and morbidities such as intraventricular-haemorrhage (IVH), chronic lung disease (CLD), patent ductus arteriosus (PDA), necrotising enterocolitis (NEC), retinopathy of prematurity (ROP) and long-term neurodevelopmental outcomes. Data were pooled separately for adjusted and unadjusted odds ratios (ORs) using random-effects model. Separate analyses were conducted for case-control and cohort studies. Data were pooled separately for the excess weight loss (EWL) group (>15% from birth weight) and inadequate weight loss (IWL) group (<5% from birth weight).Results: Eighteen studies (25158 infants) were included. Pooling of adjusted ORs in EWL group from cohort studies found significant association with mortality (OR 1.39 CI (1.10 to1.75)), severe IVH (OR 1.37 CI (1.18 to1.59)), NEC (OR 2.05 CI (1.05 to4.03)) and \"Mortality or IVH\" (OR 1.40 CI (1.10 to1.78)). Pooling adjusted ORs from case-control studies showed a significant association between EWL and CLD, and between IWL and mortality or CLD. Certainty of evidence was 'Low' or 'Very-low'.Conclusion: EWL or IWL in very-preterm infants may be associated with higher odds of mortality and morbidity. However, cofactors of severity of associated disease, insufficient nutrition, and treatments could not be assessed.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep Learning-based Multi-class Classification for Neonatal Respiratory Diseases on Chest Radiographs in Neonatal Intensive Care Units.

Neonatology Pub Date : 2025-03-06 DOI: 10.1159/000545107

Hye Won Cho, Sumin Jung, Kyu Hee Park, Jin Wha Choi, Ju Sun Heo, Jaeyoung Kim, Heerim Yun, Donghoon Yu, Jinho Son, Byung Min Choi

{"title":"Deep Learning-based Multi-class Classification for Neonatal Respiratory Diseases on Chest Radiographs in Neonatal Intensive Care Units.","authors":"Hye Won Cho, Sumin Jung, Kyu Hee Park, Jin Wha Choi, Ju Sun Heo, Jaeyoung Kim, Heerim Yun, Donghoon Yu, Jinho Son, Byung Min Choi","doi":"10.1159/000545107","DOIUrl":"https://doi.org/10.1159/000545107","url":null,"abstract":"Objective Accurate and timely interpretation of chest radiographs is essential for assessing respiratory distress and guiding clinical management to improve outcomes of critically ill newborns. This study aimed to introduce a deep learning-based automated algorithm designed to classify various neonatal respiratory diseases and healthy lungs using a large dataset of high-quality, multi-class labeled chest X-ray images from neonatal intensive care units (NICUs). Methods Portable supine chest X-ray images for six common conditions (healthy lung, respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), air leak syndrome (ALS), atelectasis, and bronchopulmonary dysplasia (BPD)) and demographic variables (gestational age and birth weight) were retrospectively collected from 10 university hospitals in Korea. Ground truth for manual classification of these conditions was generated by 20 neonatologists and validated by others from different hospitals. The dataset, consisting 34,598 for training, 4,370 for validation, and 4,370 for testing, was used to train a modified ResNet50-based deep-learning model for automatic classification. Results The automatic classification algorithm showed high concordance with human-annotated classifications, achieving an overall testing accuracy of 83.96% and an F1-score of 83.68%. The F1-score for each condition was 87.38% for \"healthy lung\", and 92.19% for \"BPD\", 90.65% for \"ALS\", 90.30% for \"RDS\", 86.56% for \"atelectasis\", and 70.84% for \"TTN\". Conclusion We introduced a deep learning-based automated algorithm to classify neonatal respiratory diseases using a large dataset of high-quality, multi-class labeled chest X-ray images, incorporating non-imaging data, which could support neonatologists in making timely and accurate decisions for critically ill newborns.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electrical impedance tomography during the extubation phase in very preterm born infants.

Neonatology Pub Date : 2025-03-03 DOI: 10.1159/000544811

Jantine J Wisse, Tom G Goos, Diederik Gommers, Henrik Endeman, André Kroon, Irwin K M Reiss, Annemijn H Jonkman

{"title":"Electrical impedance tomography during the extubation phase in very preterm born infants.","authors":"Jantine J Wisse, Tom G Goos, Diederik Gommers, Henrik Endeman, André Kroon, Irwin K M Reiss, Annemijn H Jonkman","doi":"10.1159/000544811","DOIUrl":"https://doi.org/10.1159/000544811","url":null,"abstract":"Introduction Although many preterm born infants require invasive mechanical ventilation, it is also associated with detrimental effects. Early extubation should be pursued, but extubation failure is yet common. The critical transition to non-invasive ventilation is characterized by respiratory physiological changes, warranting non-invasive monitoring. We aimed to determine whether electrical impedance tomography (EIT) could provide insights into the respiratory mechanics of neonates around extubation, and if findings were different between successful and failed extubation. Methods Single-center observational study where EIT and transcutaneous CO2 measurements were performed in preterm born infants <32 weeks gestational age. Measurements were performed from 24 hours before up to 48 hours after extubation. EIT parameters extracted from the hour before and after extubation were analysed to evaluate the short-term physiological changes. Results Twenty-one patients were included and six (29%) were reintubated. End-expiratory lung impedance and tidal impedance variation were stable around extubation (p=0.86 and p=0.47, respectively). Compared to successfully extubated patients, reintubated patients showed more lung inhomogeneity (GI index) after extubation (0.75 vs 0.84, p=0.03). The percentage of non-dependent silent spaces decreased of after extubation in successfully extubated patients (p<0.001). Body position and ventilator mode influenced these findings. Conclusion EIT measurements in preterm neonates provide valuable insight into the respiratory physiology during the transition from invasive to non-invasive ventilation, with significant differences in ventilation distribution and lung homogeneity between successfully extubated and reintubated patients. EIT has the potential to guide personalized respiratory support by assessing ventilation distribution and quantifying inhomogeneity, aiding in the optimization of ventilation settings.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inhaled nitric oxide for bronchopulmonary dysplasia-associated pulmonary hypertension: A systematic review and narrative synthesis.

Neonatology Pub Date : 2025-03-03 DOI: 10.1159/000545034

Hiroki Kitaoka, Ryota Kobayashi, Kosuke Tanaka, Masahiko Watanabe, Tetsuya Isayama

{"title":"Inhaled nitric oxide for bronchopulmonary dysplasia-associated pulmonary hypertension: A systematic review and narrative synthesis.","authors":"Hiroki Kitaoka, Ryota Kobayashi, Kosuke Tanaka, Masahiko Watanabe, Tetsuya Isayama","doi":"10.1159/000545034","DOIUrl":"https://doi.org/10.1159/000545034","url":null,"abstract":"Introduction: Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator. However, its effectiveness in the treatment of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) and severe BPD remains uncertain. Here we systematically reviewed whether iNO treatment increased or decreased mortality and morbidity among preterm infants with severe BPD or BPD-PH.Methods: We systematically searched the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane CENTRAL, and ICHUSHI databases for randomized and non-randomized studies that compared the effects of iNO in patients with severe BPD or BPD-PH. The primary outcome was mortality. Two authors independently screened the articles and extracted the data. A meta-analysis and certainty of evidence assessment using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation criteria were planned.Results: Among the 1710 articles, none had a relevant control group and no studies met the eligibility criteria. Using a post hoc analysis, we summarized the ineligible studies that evaluated patients with severe BPD or BPD-PH who received iNO therapy. Although some studies included in the narrative review indicated a decreased pulmonary arterial pressure in patients with severe BPD or BPD-PH at the initiation of iNO therapy, none included a comparator group.Conclusions: Despite the use of iNO in patients with severe BPD and BPD-PH, no published studies compared the outcomes between patients with BPD treated with versus without iNO. Although some studies without comparator groups reported the effectiveness of iNO in patients with severe BPD and BPD-PH, our results suggest that iNO therapy should be initiated with caution and careful consideration of the target population.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-22"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ChatGPT-4o in risk of bias assessments in neonatology - a validity analysis. 新生儿科偏倚风险评估中的 ChatGPT-4o - 有效性分析。

Neonatology Pub Date : 2025-02-25 DOI: 10.1159/000544857

Ilari Kuitunen, Lauri Nyrhi, Daniele De Luca

{"title":"ChatGPT-4o in risk of bias assessments in neonatology - a validity analysis.","authors":"Ilari Kuitunen, Lauri Nyrhi, Daniele De Luca","doi":"10.1159/000544857","DOIUrl":"https://doi.org/10.1159/000544857","url":null,"abstract":"Background: Only a few studies have addressed the potential of large language models (LLM) in risk of bias assessments and the results have been varying. The aim of this study was to analyze how well ChatGPT performs in risk of bias assessments of neonatal studies.Methods: We searched all Cochrane neonatal intervention reviews published in 2024 and extracted all risk of bias assessments. Then the full reports were retrieved and uploaded alongside the guidance to perform a Cochrane original risk of bias analysis in ChatGPT-4o. The concordance between the original assessment and that provided by ChatGPT-4o was evaluated by inter-class correlation coefficients and Cohen's Kappa statistics (with 95% confidence intervals for each risk of bias domain and for the overall assessment.Results: From nine reviews a total of 61 randomized studies were analyzed. A total of 427 judgements were compared. The overall kappa was 0.43 (95%CI 0.35-0.51) and the overall intraclass correlation coefficient was 0.65 (95%CI: 0.59-0.70). The Cohen's kappa was assessed for each domain and the best agreement was observed in the allocation concealment (kappa=0.73, 95%CI: 0.55-0.90), whereas the poorest agreement was found in incomplete outcome data (kappa=-0.03, 95%CI: -0.07-0.02).Conclusion: ChatGPT-4o failed to achieve sufficient agreement in the risk of bias assessments. Future studies should examine whether the performance of other LLM would be better or whether the agreement in ChatGPT-4o could be further enhanced by better prompting. Currently the use of ChatGPT-4o in risk of bias assessments should not be promoted.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maternal and Neonatal Factors Associated with Delayed Closure of Ductus Arteriosus in Term-Born Neonates: Insights from the Copenhagen Baby Heart Cohort Study. 与足月新生儿动脉导管延迟闭合有关的母体和新生儿因素：哥本哈根婴儿心脏队列研究的启示》。

Neonatology Pub Date : 2025-02-12 DOI: 10.1159/000543915

Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Raheel Altaf Raja, Anna Sellmer, Johan Navne, Henning Bundgaard, Kasper Karmark Iversen, Dorthe Lisbeth Jeppesen

{"title":"Maternal and Neonatal Factors Associated with Delayed Closure of Ductus Arteriosus in Term-Born Neonates: Insights from the Copenhagen Baby Heart Cohort Study.","authors":"Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Raheel Altaf Raja, Anna Sellmer, Johan Navne, Henning Bundgaard, Kasper Karmark Iversen, Dorthe Lisbeth Jeppesen","doi":"10.1159/000543915","DOIUrl":"https://doi.org/10.1159/000543915","url":null,"abstract":"Background The prenatal shunt, ductus arteriosus (DA), typically closes during the cardio-pulmonary transition at birth. We evaluated maternal and neonatal factors associated with delayed closure of DA in term-born neonates. Method We conducted a retrospective cohort study that included full-term neonates from the prospective observational Copenhagen Baby Heart cohort study. We assessed the association between maternal and neonatal factors and delayed ductal closure. Results We included 19,566 neonates, of whom 48% were female. Echocardiography was performed at a median age of 12 (IQR:9-15) and eight (IQR:2-13) days for neonates with no DA and an open DA, respectively. Associations with delayed ductal closure included maternal obesity adjusted risk ratio=2 (95%CI:1-3.8), maternal hypothyroidism during pregnancy aRR=2.02 (95%CI:1.2-3.4), low Apgar 2.6 (95%CI:1.2-6), high weight aRR=1.81(95%CI:1.2-2.6), and length at birth aRR=1.7(95%CI:1.1-2.6). Conclusion The identified risk factors for delayed ductal closure in term-born neonates may help increase clinical attention and improve neonatal care.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microstructural maturation of the splenium of corpus callosum and cognitive and motor outcome in very preterm infants.

Neonatology Pub Date : 2025-02-03 DOI: 10.1159/000543328

Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier

{"title":"Microstructural maturation of the splenium of corpus callosum and cognitive and motor outcome in very preterm infants.","authors":"Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.1159/000543328","DOIUrl":"https://doi.org/10.1159/000543328","url":null,"abstract":"Introduction: Common brain injuries of preterm infants do not entirely explain the incidence of neurodevelopmental impairment observed in this population. Evidence suggests an association with microstructural maturation of the splenium of corpus callosum. This study aimed to investigate a correlation between microstructural maturation of the splenium of corpus callosum and neurodevelopmental outcome in very preterm infants.Method: In a cohort study of 373 very preterm infants, we used fractional anisotropy (FA) and apparent diffusion coefficient (ADC) derived from diffusion tensor imaging at term equivalent age (TEA) to quantitatively reflect microstructural maturation of the splenium of corpus callosum, and standardized follow-up assessments of cognitive and motor function at 24 months corrected age and five years chronological age. Correlation was tested by Spearman rank´s correlation coefficients and multivariate regression analysis.Results: At 24 months, we found significantly lower FA and higher ADC values in infants with abnormal mental indices, psychomotor developmental indices and fine motor function. Scores of all three correlated positively with FA and negatively with ADC. Aged five years, lower FA values correlated significantly with abnormal overall motor function, and higher ADC values correlated significantly with abnormal full scale intelligence quotient (FSIQ) and overall motor function. Scores of FSIQ, overall and fine motor function correlated negatively with ADC.Conclusion: The results emphasize an association between microstructural maturation of the splenium of corpus callosum at TEA and neurodevelopmental outcome, and suggest that ADC may be more strongly linked to these outcomes than FA, especially in the long-term.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Macrogol to Accelerate Feeding Advancement in Extremely Preterm Infants.

Neonatology Pub Date : 2025-02-03 DOI: 10.1159/000543050

Kirstin Barbara Faust, Mariia Lupatsii, Frederike Römer, Simon Graspeuntner, Silvio Waschina, Sina Zimmermann, Alexander Humberg, Mats Ingmar Fortmann, Kathrin Hanke, Kai Böckenholt, Johannes Dirks, Christine Silwedel, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel

{"title":"Use of Macrogol to Accelerate Feeding Advancement in Extremely Preterm Infants.","authors":"Kirstin Barbara Faust, Mariia Lupatsii, Frederike Römer, Simon Graspeuntner, Silvio Waschina, Sina Zimmermann, Alexander Humberg, Mats Ingmar Fortmann, Kathrin Hanke, Kai Böckenholt, Johannes Dirks, Christine Silwedel, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel","doi":"10.1159/000543050","DOIUrl":"10.1159/000543050","url":null,"abstract":"Introduction: Delayed enteral nutrition is associated with a higher risk for adverse outcomes in extremely preterm infants. Limited evidence exists on therapeutic options to support meconium evacuation and increase gastrointestinal motility. The aim of this study was to determine the effect of macrogol on feeding tolerance and microbiome establishment in preterm infants <27 weeks of gestation.Methods: We investigated the impact of early macrogol administration in two observational cohort studies: the multi-center German-Neonatal-Network (GNN) study comparing extremely preterm infants born in neonatal intensive care units (NICUs) using macrogol in the first week of life in >30% of their infants as compared to the remaining units, and the single-center Immunoregulation-of-the-Newborn (IRoN) study including gut microbiome assessment of infants born before and after implementation of macrogol use in this NICU.Results: In the GNN study cohort including 4,290 infants, advancement to full enteral feedings was significantly faster in macrogol-using NICUs compared to the remaining NICUs (median/IQR: 14/12 vs. 16/14 days, p = 0.001). Risk for short-term outcomes such as sepsis or abdominal complications was not elevated in units with regular use of macrogol. In the IRoN cohort (n = 68), macrogol treated infants had a shorter time to reach full enteral feeding (median/IQR: macrogol 12/6, control 16/6 days, p = 0.004). Higher Bifidobacterium longum abundance in the gut microbiome correlated with acceleration to full enteral nutrition.Conclusion: Our observational data suggests that early off-label use of macrogol may support feeding advancement in highly vulnerable babies. These data provide a basis for a randomized controlled trial.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of a New Classification for Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants: Insights from a Large Japanese Cohort.

Neonatology Pub Date : 2025-01-27 DOI: 10.1159/000543810

Hidehiko Nakanishi, Masato Ito, Shin Kato, Makoto Saito, Naoyuki Miyahara, Hirokazu Arai, Erika Ota, Fumihiko Namba

{"title":"Validation of a New Classification for Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants: Insights from a Large Japanese Cohort.","authors":"Hidehiko Nakanishi, Masato Ito, Shin Kato, Makoto Saito, Naoyuki Miyahara, Hirokazu Arai, Erika Ota, Fumihiko Namba","doi":"10.1159/000543810","DOIUrl":"10.1159/000543810","url":null,"abstract":"Introduction: A recent scoping review identified histological chorioamnionitis (HCA), small for gestational age (SGA), and bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as risk factors for severe bronchopulmonary dysplasia (BPD). To further validate these results, a large-scale database was analyzed.Methods: This retrospective multicenter cohort study included infants born at <28 weeks' gestational age between 2003 and 2016. The validated risk factors identified from the scoping review were analyzed for independent associations with severe BPD using multivariable logistic regression. Additionally, the association of these factors with long-term outcomes at 3 years, including home oxygen therapy (HOT) and neurodevelopmental impairments (NDIs), was analyzed.Results: Among 15,834 extremely preterm infants, HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were significantly and independently associated with severe BPD (adjusted odds ratio, 1.20; 95% confidence interval, 1.06-1.36) (1.73; 1.51-1.98) (1.79; 1.60-2.01), respectively. These three factors were also linked to HOT at 3 years (1.54; 1.14-2.08) (1.70; 1.21-2.39) (2.63; 1.94-3.56), respectively. Their combination significantly increased the prevalence of severe BPD and HOT at 3 years, particularly with bubbly/cystic CXR. Only SGA was independently associated with NDIs in BPD infants (1.55; 1.32-1.83).Conclusions: HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were identified as important risk factors for severe BPD and long-term respiratory outcomes. While further research is needed to validate their role in endotype-specific classification of BPD, these findings may contribute to early prognostic strategies and targeted interventions before 36 weeks' postmenstrual age.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.

Neonatology Pub Date : 2025-01-22 DOI: 10.1159/000543605

Ekaterina Dianova, Nara S Higano, Kera M McNelis, Shelley R Ehrlich, Chunyan Liu, Jason C Woods, Paul S Kingma

{"title":"Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.","authors":"Ekaterina Dianova, Nara S Higano, Kera M McNelis, Shelley R Ehrlich, Chunyan Liu, Jason C Woods, Paul S Kingma","doi":"10.1159/000543605","DOIUrl":"10.1159/000543605","url":null,"abstract":"Introduction: Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates.Methods: In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed.Results: The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p < 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p < 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04).Conclusion: Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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