Rates of Bronchopulmonary Dysplasia in Very Preterm Neonates in Europe: Results from the MOSAIC Cohort

Gortner, Ludwig; Misselwitz, Björn; Milligan, David; Zeitlin, Jennifer; Kollée, L.A.A.; Boerch, Klaus; Agostino, Rocco; Reempts, Patrick Van; Chabernaud, J.-L.; Breart, Gérard; Papiernik, E; Jarreau, Pierre‐Henri; Carrapato, Manuel Rui Garcia; Gadzinowski, Janusz; Draper, Elizabeth S

doi:10.1159/000313024

Cited by 117 publications

(93 citation statements)

References 38 publications

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“…These were not the expected results and could help explain the contradictory findings in the literature. Indeed, previous studies found a positive association 21,23,33 or no association 10,25,34 between placentamediated complications and BPD. However, a few studies distinguished between preeclamptic women with and without FGR.…”

Section: Discussionmentioning

confidence: 95%

Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study

et al. 2016

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OBJECTIVE: To investigate the relationship between placenta-mediated pregnancy complications and bronchopulmonary dysplasia (BPD) in very preterm infants.METHODS: National prospective population-based cohort study including 2697 singletons born before 32 weeks' gestation. The main outcome measure was moderate to severe BPD. Three groups of placenta-mediated pregnancy complications were compared with no placenta-mediated complications: maternal disorders only (gestational hypertension or preeclampsia), fetal disorders only (antenatal growth restriction), and both maternal and fetal disorders. RESULTS:Moderate to severe BPD rates were 8% in infants from pregnancies with maternal disorders, 15% from both maternal and fetal disorders, 23% from fetal disorders only, and 9% in the control group (P < .001). When we adjusted for gestational age, the risk of moderate to severe BPD was greater in the groups with fetal disorders only (odds ratio [OR] = 6.6; 95% confidence interval [CI], 4.1-10.7), with maternal and fetal disorders (OR = 3.7; 95% CI, 2.5-5.5), and with maternal disorders only (OR = 1.7; 95% CI, 1.0-2.7) than in the control group. When we also controlled for birth weight, the relationship remained in groups with fetal disorders only (OR = 4.2; 95% CI, 2.1-8.6) and with maternal and fetal disorders (OR = 2.1; 95% CI, 1.1-3.9).CONCLUSIONS: Placenta-mediated pregnancy complications with fetal consequences are associated with moderate to severe BPD in very preterm infants independently of gestational age and birth weight, but isolated maternal hypertensive disorders are not. Fetal growth restriction, more than birth weight, could predispose to impaired lung development.

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Section: Discussionmentioning

confidence: 95%

Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study

et al. 2016

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“…BPD rates ranged from 10.2 to 24.8% for infants between 23-31 wk of gestations in the MOSIAC cohort of 10 European regions (29). The overall incidence of BPD or death was 52%; ranging from 32 to 74% across NICHD Neonatal Research Network centers in infants below 1,250 g (30).…”

Section: Vitamin D Receptor and Bpdmentioning

confidence: 96%

Association of vitamin D receptor gene polymorphisms and bronchopulmonary dysplasia

et al. 2014

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Background: Vitamin D and its receptor (VDR) have important roles in perinatal lung development. The aim of this study was to investigate the relationship between VDR gene polymorphism and bronchopulmonary dysplasia (BPD) in preterm infants. Methods: VDR Fok I, Bsm I, Apa I, and Taq I polymorphisms were genotyped using restriction fragment length polymorphism in 109 preterm infants (47 with BPD, 62 without BPD). results: In univariate analysis, Ff (odds ratio (OR) = 3.937, P = 0.022, 95% confidence interval (CI) = 1.22-12.69) and ff (OR = 5.23, P = 0.004, 95% CI = 1.69-16.23) genotypes of Fok I were associated with the increased risk of BPD; whereas tt genotype of Taq 1 was associated with a protective effect against BPD (OR = 0.30, P = 0.04, 95% CI = 0.09-0.94). In multivariate logistic regression analysis, variant Fok 1 genotype increased risk of BPD (OR = 4.11, 95% CI = 1.08-15.68, P = 0.038) independent of patent ductus arteriosus, sepsis, mechanical ventilation, and surfactant treatment. Taq 1, Bsm 1, and Apa 1 polymorphisms did not have any effect. conclusion: After adjusting for multiple confounders, VDR Fok 1 polymorphism was associated with the increased frequency of BPD. Further studies are needed to assess the contribution of VDR signaling to the pathogenesis of BPD and to determine if VDR polymorphisms may be suitable for identifying infants at high risk for BPD.

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“…Several recent reports have shown that maternal hypertensive disorders of pregnancy are associated with a higher risk for BPD 5,6,14,22 ; however, the underlying mechanism has only recently been clarified in experimental animal studies. Preeclampsia is characterized by maternal endothelial dysfunction that leads to hypertension, proteinuria, and other complications.…”

Section: Figurementioning

confidence: 99%

Association of Maternal Hypertension and Chorioamnionitis With Preterm Outcomes

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: In very preterm infants, outcomes depend not only on the degree of immaturity, but also on the underlying pathologies that trigger preterm delivery. Studies that have addressed this issue have provided unclear results.WHAT THIS STUDY ADDS: Patterns of outcomes differ between maternal hypertension and chorioamnionitis: hypertension is associated with greater risks for bronchopulmonary dysplasia and retinopathy of prematurity, and lower risks for brain injury, necrotizing enterocolitis, early-onset sepsis. For mortality, the effect changes across gestational age weeks. abstract OBJECTIVES: We compared the relative effect of hypertensive disorders of pregnancy and chorioamnionitis on adverse neonatal outcomes in very preterm neonates, and studied whether gestational age (GA) modulates these effects. METHODS:A cohort of neonates 23 to 30 weeks' GA, born in 2008 to 2011 in 82 hospitals adhering to the Italian Neonatal Network, was analyzed. Infants born from mothers who had hypertensive disorders (N = 2096) were compared with those born after chorioamnionitis (N = 1510). Statistical analysis employed logistic models, adjusting for GA, hospital, and potential confounders. RESULTS:Overall mortality was higher after hypertension than after chorioamnionitis (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.08-1.80), but this relationship changed across GA weeks; the OR for hypertension was highest at low GA, whereas from 28 weeks' GA onward, mortality was higher for chorioamnionitis. For other outcomes, the relative risks were constant across GA; infants born after hypertension had an increased risk for bronchopulmonary dysplasia (OR, 2.20; 95% CI, 1.68-2.88) and severe retinopathy of prematurity (OR, 1.48; 95% CI, 1.02-2.15), whereas there was a lower risk for earlyonset sepsis (OR, 0.25; 95% CI,, severe intraventricular hemorrhage (OR, 0.65; 95% CI, periventricular leukomalacia (OR, 0.70; 95% CI,, and surgical necrotizing enterocolitis or gastrointestinal perforation (OR, 0.47; 95% CI, 0.31-0.72).CONCLUSIONS: Mortality and other adverse outcomes in very preterm infants depend on antecedents of preterm birth. Hypertension and chorioamnionitis are associated with different patterns of outcomes; for mortality, the effect changes across GA weeks. Pediatrics 2014;134:e154-e161 AUTHORS:

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Rates of Bronchopulmonary Dysplasia in Very Preterm Neonates in Europe: Results from the MOSAIC Cohort

Cited by 117 publications

References 38 publications

Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study

Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study

Association of vitamin D receptor gene polymorphisms and bronchopulmonary dysplasia

Association of Maternal Hypertension and Chorioamnionitis With Preterm Outcomes

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