ESPE2022 Poster Category 1 Fetal, Neonatal Endocrinology and Metabolism (30 abstracts)
Bronchopulmonary dysplasia is not related to neurofilament light chain for neuroaxonal damage in preterm infants
Michelle Romijn 1,2,3 , Emma Baas 1 , Birgit Lissenberg-Witte 4 , Wes Onland 2,3 , Marsh Königs 5,3 , Jaap Oosterlaan 6,3 , Hans ~ Heijst 7 , Joost Rotteveel 1,3 , Anton van Kaam 2,3 , Charlotte Teunissen 7 & Martijn Finken 1,3
1Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Pediatric Endocrinology, Amsterdam, Netherlands; 2Amsterdam UMC Location University of Amsterdam, Department of Neonatology, Amsterdam, Netherlands; 3Amsterdam Reproduction & Development, Amsterdam, Netherlands; 4Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, Netherlands; 5Amsterdam UMC Location University of Amsterdam, Emma Neuroscience Group, Amsterdam, Netherlands; 6Amsterdam UMC Location University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me program & Emma Neuroscience Group, Amsterdam, Netherlands; 7Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience, Amsterdam, Netherlands
Rationale: Bronchopulmonary dysplasia (BPD) is a common complication after preterm birth that is associated with neurodevelopmental impairment. Neurofilament light chain (NfL) has been identified as a biomarker for neuroaxonal damage in preterm infants, but its relation with BPD has not yet been established. We hypothesized that BPD is associated with increased NfL levels at an early stage, indicative of early neuroaxonal damage.
Methods: In this prospective observational study we included preterm infants born <30 weeks of gestation, admitted to the Neonatal Intensive Care Units of Amsterdam UMC between October 2019 and March 2021. Serum NfL levels were determined using Simoa assay in cord blood and blood obtained at postnatal days 3, 7 and 14. Linear regression analysis was used to compare NfL levels between infants with moderate/severe BPD (BPD group) and infants with no/mild BPD (no BPD group), while linear mixed model analysis was performed to assess the effect of time on NfL levels between the two groups. Next, analyses were adjusted for gestational age (GA) and small for gestational age (SGA).
Results: Sixty-seven infants with a GA of 27±1.3 weeks were included for analysis, of whom 19 infants (28%) developed moderate/severe BPD. Although the NfL levels were significantly higher at every time point in the BPD group, statistical significance was lost after adjusting for GA and SGA (Table 1). No differences were found between the groups in NfL change over time.
| No BPD (n=48) |
BPD (n=19) |
Crude results | Adjusted results | |||||
| Median [IQR] | Median [IQR] | B | 95%-CI | P-value | B | 95%-CI | P-value | |
| NFL CONCENTRATION (Pg/mL) | ||||||||
| Day 1 | 19.9 [16.1, 25.5] | 26.6 [20.3, 42.8] | 1.52 | 1.03, 2.25 | 0.04 | 1.31 | 0.91, 1.88 | 0.14 |
| Day 3 | 56.4 [39.0, 94.2] | 106.6 [82.8, 184.1] | 1.98 | 1.40, 2.81 | <0.001 | 1.35 | 0.90, 2.04 | 0.15 |
| Day 7 | 67.2 [53.5, 100.4] | 95.9 [76.7, 136.7] | 1.49 | 1.11, 1.99 | 0.01 | 1.04 | 0.75, 1.44 | 0.83 |
| Day 14 | 32.2 [24.7, 51.5] | 56.4 [30.2, 65.9] | 1.57 | 1.07, 2.32 | 0.02 | 1.37 | 0.85, 2.20 | 0.20 |
Conclusion: We showed that the positive association between BPD and NfL among preterm infants in their first weeks of life could be explained by GA and SGA rather than by the development of BPD.
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