Correlation Between Early Postnatal Body Weight Changes and Lung Ultrasound Scores as Predictors of Bronchopulmonary Dysplasia in Preterm Infants; A Secondary Analysis of a Prospective Study

Abstract

Abstract Purpose of the study: Recent research links Early Weight-Changes (EWC) with bronchopulmonary dysplasia (BPD) in preterm neonates, while lung ultrasound score (LUS) has shown promise in predicting BPD. We aimed to explore the correlation between LUS and EWC as markers of extravascular lung edema. Objective: To investigate the correlation between LUS and EWC in preterm infants with respiratory distress syndrome regarding future BPD development. Methods: This secondary analysis of a prospective study involved infants ≤ 28 weeks' gestation. Enrolled infants underwent lung ultrasound assessment on postnatal days 3, 7 and 14, measuring LUS. Respiratory severity score (RSS) and EWC were computed on the same time-points. Infants were classified as either having BPD or not. Descriptive statistics, Correlation Coefficient, and Area Under the Receiver Operating Characteristic Curve (AUROC) analysis were utilized. Results: Of 132 infants, 70 (53%) had BPD. Univariate analysis revealed statistically significant differences in LUS, EWC, and RSS at days 3, 7, and 14 between BPD and no-BPD groups (p < 0.001). A statistically significant but weak positive correlation existed between LUS and EWC at all three assessment points. AUROC analysis indicated LUS having superior predictive capacity for the need for invasive mechanical ventilation at day 14 as well as the later BPD development compared to EWC (p < 0.0001). Conclusions: In a cohort of extreme preterm infants, our study revealed a positive yet weak correlation between LUS and EWC, suggesting that EWC was not the major contributing to the evolving chronic lung disease.