Combined Gestational Age and Serum Fucose for Early Prediction of Risk for Bronchopulmonary Dysplasia in Premature Infants

Abstract

Abstract Objective: Bronchopulmonary dysplasia (BPD) is the most complication of premature infants, accurate identification of at-risk infants and early intervention are key to improve outcomes. The objective of this study is to explore a multifactorial model to predict the risk of BPD. Materials and methods: A total of 148 neonates with gestational age ≤ 32 weeks were recruited. Clinical data and serum samples at 1week after birth were collected. Content of serum free monosaccharides and degraded monosaccharides were analyzed by high-performance liquid chromatography (HPLC). The logistic regression analysis was drawn to build models for the early diagnosis of BPD. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of different monosaccharides for BPD, and combined with clinical data to improve the diagnostic efficiency, which was calculated using the area under the curve (AUC). Results: Of the 148 eligible infants, 42 developed BPD (28.38%), which consist of 71.43% mild (30/42) and 28.57%moderate-severe (12/42) cases. The significant risk factors for BPD in the multivariate analysis of clinical data and serum monosaccharides were gestational age, birth-weight, the duration of invasive mechanical ventilation and non-invasive ventilation, patient ductus arteriosus (PDA) and pregnancy-induced hypertension, glucose (Glc-F), mannose (Man-F), fucose (Fuc-D), galactosamine (GalN-D), galactose (Gal-D), glucose (Glc-D) and mannose (Man-D). In addition, the concentration of Glc-D and Fuc-D inmoderate-severe BPD group were significantly lower than those in mild BPD group. The combination of gestational age and Fuc-D determined the risk of developing BPD, with an AUC value of 0.9964. Conclusion: The prediction model based on the gestational age and Fuc-D predicts the development of BPD with high sensitivity (95.24%) and specificity (93.24%) and might facilitate early intervention and improve outcome.