Association Between Preterm Infants’ Bronchopulmonary Dysplasia And Serum Albumin Level 24 Hours After Delivery

Objective:To investigate the Association between preterm infants’ bronchopulmonary dysplasia and serum albumin level 24 hours after delivery.Methods:There was a case-control investigation.According to the diagnostic criteria for BPD,preterm infants with a gestational age of 32 weeks and a birth weight of 1500 g who were admitted to the neonatal intensive care unit of the Affiliated Hospital of Chengde Medical College within 24 hours of birth were chosen and divided into the BPD group and control group.About 24 hours following birth,total protein(TLP),serum albumin(ALB),creatinine(Cr),and urea nitrogen(BUN)levels were measured in addition to general clinical information.A statistical comparison of the variations between the two groups was done.Results:A total of 138 neonates who met the criteria were included.The proportions of premature infants with gestational age < 28 weeks,28 weeks ≤gestational age < 29 weeks,29 weeks ≤ gestational age < 30 weeks,30 weeks≤ gestational age < 31 weeks,and 31 weeks ≤ gestational age ≤ 32 weeks were 20.3 %,18.8 %,15.9 %,29.0 %,and 15.9 %,respectively.The proportion of children with gestational age < 28 weeks in the BPD group(30.7%)was higher than that in the control group(7.9%).The proportion of children with 28 weeks ≤ gestational age < 29 weeks(28.0%)was higher than that in the control group(7.9%).The proportion of children with 29 weeks ≤ gestational age < 30 weeks(14.7%)was lower than that of the control group(17.5%).The proportion of children with 30 weeks ≤ gestational age < 31 weeks(21.3%)was lower than that of the control group(38.1%).The proportion of children with 31 weeks ≤ gestational age ≤ 32 weeks(5.3%)was lower than that of the control group(28.6%).The proportion of mothers with gestational hypertension in BPD group(48.0%)was lower than that in control group(55.6%).The proportion of gestational diabetes mellitus in BPD group(20.0 %)was lower than that in control group(27.0%).The proportion of adequate prenatal hormone application in BPD group(53.3%)was lower than that in control group(61.9%).The proportion of multiple births in BPD group(25.3%)was higher than that(17.5%).The proportion of cesarean section births in the BPD group(74.7%)was lower than that in the combat group(87.3);for boys,the proportion of BPD group(68%)was higher than that of control group(42.9%).The proportion of birth asphyxia in BPD group(29.3%)was higher than that in control group(22.2%).The average gestational age of the two groups was(28.88±1.51)weeks in the BPD group and(30.33±1.28)weeks in the control group.The birth weight(1140.8±209.4)g in the BPD group was less than the average gestational age(1260.8±181.7)g in the control group.The proportion of pulmonary surfactant(PS)in BPD group(89.3%)was higher than that in control group(69.8%).The proportion of neonatal respiratory distress syndrome(NRDS)in BPD group(97.3%)was higher than that in control group(96.8%).Postnatal infection(including neonatal pneumonia,sepsis,ventilator-associated pneumonia,neonatal infection),the proportion of BPD group(78.7%)was higher than that of the control group(65.1%).The proportion of mechanical ventilation time > 24 h in BPD group(36%)was higher than that in control group(14.3%).The average time to reach full gastrointestinal tract in BPD group(27.71±10.70)days was longer than that in control group(22.56)days.1 Comparison of general clinical data between the two groupsGestational age and body weight in BPD group were lower than those in control group,and the difference was statistically significant(P<0.05);the cases of Boy,the application of Pulmonary surfactant after birth,mechanical ventilation time >24hours,the time to reach the whole gastrointestinal tract were higher than control group,hers with gestational hypertension,gestational diabetes,birth asphyxia,NRDS,multiple births and postnatal infection in BPD group was higher than that in control group,and the difference was not statistically significant(P>0.05);The proportion of cesarean section and prenatal hormone dosage was lower than control group,and the difference was not statistically significant(P>0.05).2 Comparison of serum levels of total protein,albumin,creatinine and urea nitrogen and ratio of total protein/albumin and urea nitrogen/creatinine at24 hours after birthIn the BPD group,the levels of TP was(39.53±5.33)g/L,ALB was(25.15±3.49)g/L、Cr was(86.74±27.11)μmol/L、BUN was(6.05±2.34)mmol/L、the ratio of TP/ALB was(1.58±0.17)、 the ratio of BUN/Cr was(7.21±2.58);in the control group,the levels of TP was(43.57±5.09)g/L、ALB was(27.61±3.12)g/L、Cr was(80.95±21.19)μmol/L、BUN was(5.45±2.22)mmol/L、the ratio of TP/ALB was(1.57±0.14)、the ratio of BUN/Cr was(6.91±2.75).The levels of TP and ALB in BPD group were lower than those in control group,and the difference was statistically significant(P<0.05);The levels of Cr、BUN,the ratios of TP/ALB and BUN/Cr were higher than those of control group,with no statistical significance(P>0.05).3 Comparison of serum albumin levels at 24 hours after birth at different GAThe level of ALB at 24 hours after birth in GA <28 weeks group was(24.22±3.28)g/L、in the 28 weeks≤GA <29 weeks group was(25.88±3.06)g/L、in the 29weeks≤GA <30 weeks group was(26.78±3.31)g/L 、 in the 30weeks≤GA <31 weeks group was(26.45±3.79)g/L、in the 31 weeks≤ GA≤32weeks group was(28.53±2.73)g/L.Bonferrroni method was used for multiple comparisons.The results showed that the ALB level at 24 hours after birth in the GA <28 weeks group was significantly different from that in the 31 weeks≤GA≤32 weeks group(P<0.05),while pair-to-pair comparisons among the other groups showed no statistically significant differences(P>0.05).4 Multivariate Logistic regression analysisGestational age,body weight,boy,application of pulmonary surfactant after birth,mechanical ventilation time >24h,and time to reach the whole gastrointestinal tract were compared for statistically significant differences in general data;the level of TP and ALB were statistically significant in the biochemical indexes of 24 hours after birth,They were included in multivariate Logistic regression analysis,The result shows that the odds ratio of Serum albumin level within 24 hours after birth is 0.827,95% confidence interval is1.824 to 11.568),the odds ratio of Gestational age is 0.662,95% confidence interval is 0.467 to 0.939,the odds ratio of male is 4.593,95%confidence interval is 824 to 11.568,the odds ratio of mechanical ventilation time > 24 hours is 3.373,95% confidence interval is 1.121 to 10.151,Therefore,high serum albumin level within 24 hours after birth and large gestational age are protective factors for BPD in preterm infants,while boys and mechanical ventilation time >24 hours are risk factors for BPD,and the correlation is statistically significant(P<0.05).Conclusions:High serum albumin level within 24 hours after birth is a protective factor for BPD in preterm infants,which may play a protective role in various ways.