Correlation Between Hematological Parameters And Bronchopulmonary Dysplasia At Different Time After Birth

Background:With advances in reproductive technology and neonatal medicine,the survival rate of preterm infants has increased dramatically;however,because of the immaturity of various organ systems,surviving preterm infants are more susceptible to a range of long-term or short-term conditions,such as bronchopulmonary dysplasia.As we know,the systemic inflammatory response plays an important role in the development of BPD.The exact mechanism is not yet known,but its main feature is the accumulation of neutrophils,monocytes and platelets in the airways and lung tissue of preterm infants and the subsequent release of a series of inflammatory factors that impede lung development and damage lung tissue.In addition,it has been demonstrated that the lung circulation contains a large number of megakaryocytes,where they dynamically release platelets,meaning that these detectable parameters easily found in blood routines test are highly likely to be associated with bronchopulmonary development and to predict its occurrence.Objective:In this study,the correlation and clinical significance between the blood parameters of hospitalized very preterm infants and the development of BPD were investigated by assessing the blood parameters after birth,to explore whether these parameters can predict the development of BPD and to provide new ideas for neonatologists in the clinical management of children with BPD.Methods:444 preterm infants admitted to our NICU between 2019 and 2020 with gestational age<32 weeks were divided into non-BPD group or BPD group.Relevant clinical data were collected and the infants’ hematological parameters(N,M,E,PLT,MPV,PDW,PCT)were recorded at different times after birth,and a multivariate analysis was performed to assess the independence of the relationship between parameters with significant differences and the risk of BPD and its predictive value for its occurrence.Results:1.At day 1,2,3,7,14 and 28,the differences in neutrophil and monocyte counts were significant among the two groups,with the two parameters significantly higher in BPD group than in the non-BPD group.2.At day 7,eosinophil counts differed significantly among the two groups,with the BPD group significantly higher than the non-BPD group.3.At day 7,14 and 28,the differences of platelet count and PCT were significant among the two groups,with the BPD group being significantly lower than the nonBPD group.4.At day 3,7,14 and 28,both MPV and PDW were significantly different among the two groups,among which,the two parameters were significantly higher in the BPD group than in the non-BPD group.5.The time of invasive mechanical and non-invasive auxiliary ventilation,PDW at day 3 and 7,and monocyte count at day 7 are independent risk factors of BPD.The PDW at day 3 and 7,monocyte count at day 7 can predict the occurrence of BPD,with AUC of 0.645,0.706,and 0.731,respectively.Conclusions:1.The occurrence of BPD is affected by many factors.The time of invasive mechanical and non-invasive ventilation,PDW value at day 3 and day 7,and monocyte count at day 7 are independent risk factors of BPD.2.Monocyte counts>1.417 × 109/L will increase the risk of BPD.3.Both PDW>16.68%at day 3 and PDW>16.91%at day 7 significantly increased the risk of BPD.They have some predictive value for the occurrence of BPD,and the latter is more predictive of the development of BPD.