Prediction of bronchopulmonary dysplasia, retinopathy of prematurity, and periventricular leukomalacia in extremely preterm newborns

Introduction. Specific perinatal pathologies in extremely preterm infants include bronchopulmonary dysplasia, retinopathy of prematurity and periventricular leukomalacia, which can subsequently lead to disability. It is necessary to identify new prognostic markers for the development of these pathologies for a personalized approach to the management of such patients. Aim. To analyze early perinatal outcomes in extremely preterm infants with perinatal lesions of the central nervous system and to establish new predictors of their development.

Materials and methods. An analysis of the frequency of formation of specific perinatal pathology (bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), periventricular leukomalacia (PVL)) was conducted in 66 extremely preterm newborns at the time of discharge from the hospital; Their condition was assessed at birth and during the neonatal period, including an assessment of physical development. Neuromodulin (growth-associated protein 43 (GAP-43)) was measured in the serum on the first day of life.

Results and discussion. Most infants (98.5%) were born in a state of asphyxia and required resuscitation. In the neonatal period, cerebral ischemia and congenital pneumonia were diagnosed in 100% of children. Intraventricular hemorrhage occurred in 27.3% of those examined, anemia in 60.6%, and neonatal jaundice in 48.5% of infants. Infants with BPD and ROP had lower growth rates, more often required invasive mechanical ventilation or longer-term CPAP with elevated oxygen concentrations, and also had longer stays in the intensive care unit. The level of growth protein GAP-43 in the groups of children with BPD and ROP was statistically significantly lower than in children without these outcomes (p = 0.035).

Conclusion. The frequency of specific perinatal pathology in extremely preterm infants by the end of the neonatal period was established: BPD – 15.2%, ROP – 21.2%, PVL – 6.1%. The concentration of GAP-43 was determined for early prediction of the development of these pathologies.

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