Preeclampsia and the Risk of Bronchopulmonary Dysplasia in Preterm Infants Less Than 32 Weeks' Gestation

Abstract

Angiogenesis is essential for normal lung development. The objective of our study was to test the hypothesis that preeclampsia, an antiangiogenic state, is a risk factor for bronchopulmonary dysplasia (BPD). Prospective cohort study of infants less than 32 weeks' gestation born to mothers with preeclampsia between January 2007 and June 2010 at a single tertiary care center. Their BPD outcome was compared with infants born to the next two normotensive mothers with a ± 1 week gestational age difference. BPD was defined as oxygen dependency at 36 weeks' postmenstrual age. Multivariable binary regression was used to estimate the risk ratio (RR) of BPD with preeclampsia exposure and adjust for confounders. Of 102 infants in the preeclampsia group, 23 (23%) developed BPD and of the 217 infants in the normotensive group, 56 (26%) developed BPD. On multivariable binary regression modeling, preeclampsia was not a risk factor for development of BPD (RR: 0.5, 95% confidence interval [CI]: 0.20-1.20). Surfactant use, Score for Neonatal Acute Physiology Perinatal Extension-II score, sepsis, blood transfusion, and intrauterine growth restriction (IUGR) were significant risk factors for BPD. In our cohort, preeclampsia was not a significant risk factor for BPD. IUGR infants of preeclamptic and normotensive mothers were at higher risk for BPD.

Bronchopulmonary dysplasia in neonates born to mothers with preeclampsia: Impact of small for gestational age

“…Lastly, Soliman et al . didn’t find any association between preeclampsia and BPD development in a Canadian population of premature less than 32 week’s gestation [ 30 ].…”

Association of Antibiotic Utilization and Neurodevelopmental Outcomes among Extremely Low Gestational Age Neonates without Proven Sepsis or Necrotizing Enterocolitis

“…18 Babies born at the threshold of viability, small for gestational age, or to mothers with chorioamnionitis are prone to develop various complications such as respiratory distress syndrome, hypoglycemia, patent ductus arteriosus, and BPD. [19][20][21][22] Their clinical features, such as increased ventilatory settings, poor perfusion, or simply being "less active," may not be easily distinguished from infectious etiologies in the very beginning. Given the immature immune system development in preterm infants, a low threshold for sepsis evaluation with empirical antimicrobial coverage is not uncommon to avoid potentially deleterious outcomes of fulminant sepsis.…”

Tobacco Smoking During Pregnancy Is Associated With Increased Risk of Moderate/Severe Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

“…Sixteen studies reported data on BPD28 (15,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) and metaanalysis could not find a significant association between maternal smoking and this outcome (RR 1.021, 95% CI 0.924-1.129, p = 0.681) (Figure 2). In contrast, the meta-analysis of the 17 studies that reported data on BPD36 (7,8,16,39,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) showed a significant association of maternal smoking with this outcome (RR 1.126, 95% CI 1.008-1.259, p = 0.036) (Figure 3). According to the GRADE methodology, the quality of the evidence on the association between maternal smoking and BPD36 was rated as low because of moderate RoB (see above) and low magnitude of the association (20).…”