The Relationship Between Cord Blood Cytokine Levels And Perinatal Factors And Bronchopulmonary Dysplasia

Background and ObjectivesBronchopulmonary dysplasia(BPD)is a common chronic lung disease that has a high incidence and mortality in preterm infants,especially in extremely low birth weight infants(ELBWI)and very-low-birth-weight infants(VLBWI).The morbidity and mortality rates are high in preterm infants,especially in extremely low birth weight infants(ELBWI)and very-low-birth-weight infants(VLBWI),and the lung sequelae of severe BPD can persist for a long time,and the incidence of neurodevelopmental outcome is also high,which seriously affects the long-term survival quality of preterm infants.With the rapid improvement of neonatal intensive care medicine,the survival rate of ELBWI and VLBWI has increased significantly,while the incidence of BPD has not improved accordingly.Studies have shown that small for gestational age,low weight,premature rupture of membranes,genetic factors,and ventilator-induced lung injury can lead to the development of BPD,and the etiology is complex and the pathogenesis is not yet clear.Further studies on the causative factors and pathogenesis of BPD in preterm infants are beneficial to the development of disease prevention and treatment measures.The aim of this study is to investigate the correlation between the level of inflammatory cytokines in cord blood and the occurrence of BPD in preterm infants through the analysis of the correlation between the level of inflammatory cytokines in cord blood and the occurrence of BPD in preterm infants,so as to provide a theoretical basis for the study of the pathogenesis of BPD,the exploration of independent influencing factors with the ability to predict the occurrence of BPD,and the establishment of effective preventive measures.MethodsIn this study,147 premature infants who were born in the obstetrics of our hospital from July 2019 to August 2021 and directly admitted to the neonatal intensive care unit(NICU),gestational age(GA)≤ 32 weeks,cord blood cytokine detection within 24 hours of birth,no major congenital malformations and chromosomal diseases,and reached the discharge standard after treatment were selected as the subjects,The demographic characteristics,delivery characteristics,maternal and neonatal characteristics(including cord blood cytokine levels)and other clinical data were collected.According to the outcome of BPD,the subjects were divided into BPD group and control group(non BPD group).The basic clinical data characteristics of the two groups were analyzed by univariate and multivariate logistic regression to explore the independent influencing factors of BPD,variables with P<0.05 in the univariate logistic regression analysis were included in the multivariate logistic regression to determine the final model.P<0.05 was statistically significant.Results1.univariate analysis:birth weight was lower in the BPD group than in the control group(1178.83±278.77g vs 1332.76±315.03g),The difference was statistically significant(P<0.05);GA,small for gestational age(SGA),sex,mode of delivery,placental abnormalities,amniotic fluid-fetal feces There were no significant differences between the two groups for GA,small for gestational age(SGA),sex,mode of delivery,placental abnormality,amniotic fluid-fecal contamination,and 1and 5-minute Apgar scores(all P>0.05).The maternal WBC count at delivery was higher in the BPD group than in the control group(11.74×109/L vs.10.23×109/L,OR=1.121,P<0.05);cord blood IL-6 levels were significantly higher in the BPD group than in the non-BPD group,median 2.05 vs.0.50pg/ml,(OR=1.012,P<0.05).The levels of the remaining cytokines(IL-4,10,12,17 and TNF-α,IFN-γ,etc.)were not significantly correlated with BPD(all P>0.05).2.After adjusting for confounders,the results of multivariate regression analysis showed that birth weight,maternal WBC count at delivery,and IL-6 level in cord blood were independent risk factors for BPD.The risk of developing BPD was reduced by 0.2%for each 1g increase in birth weight(OR=0.998;95%CI,0.996-0.999;P<0.05);the risk of developing BPD in preterm infants was increased to 1.112-fold for each 1*109/L increase in maternal WBC count at delivery(OR=1.112;95%CI,1.006-1.229;P<0.05),and for every 50 pg/ml increase in cord blood IL-6 levels at birth,the risk of developing BPD in preterm infants increased to 1.014-fold(OR=1.014,95%CI,1.003-1.025;P<0.05).Conclusions1.For the first time,it was found that the maternal white blood cell count at delivery was positively correlated with the occurrence of BPD,and it was confirmed that birth weight was negatively correlated with BPD,and the level of IL-6 in umbilical cord blood at birth was positively correlated with the occurrence of BPD.2.Umbilical cord blood IL-6 level at birth and maternal white blood cell count at delivery are independent risk factors for BPD,and have the potential to be independent predictors of BPD.