Prediction of infants who may develop bronchopulmonary dysplasia in preterm babies with respiratory distress syndrome

ABSTRACT

The objective of this study was to test the neonatal polymorphism of TNF alpha to measure the day one levels of sL-selectin, sE-selectin and sICAM-1 in sera of neonate and placenta growth factor in cord blood, for the prediction of development of bronchopulmonary dysplasia [BPD]. The study design was a cross sectional one. Forty preterm neonates with respiratory distress and 10 normal full term neonates were enrolled. The neonates were divided into 2 subgroups; 15 who developed bronchopulmonary dysplasia and 25 without. Sampling was done and diagnostic evaluation of all parameters was accomplished. The results proved that infants. None of the infants with BPD carried the AA TNF- alpha -238 genotype, compared with 3 infants without BPD, and only 1 infant with BPD carried the GA TNF- alpha -238 genotype, compared with 7 infants without BPD. Higher sE-selectin has a diagnostic ability [sensitivity 73%, specificity 76%] higher PLGF has a sensitivity of 67% and specificity 68%. Combination of both, improved specificity to 80%. If we add to them, cases which have absence of GA TNF- alpha -238 genotype, we have got a very high sensitivity [93%] but with lower specificity. Combined all data supported a specificity 80% with a sensitivity of 86%. What had been found in this study might clarify the role of adhesion molecules, P1GF and TNF polymorphism as biological marker to determine which premature infants with RDS are at risk for development of BPD and to permit early intervention and might provide a new therapeutic target to prevent BPD