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Early biomarkers as predictors for bronchopulmonary dysplasia in preterm infants: a systematic review

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Abstract

Background

Bronchopulmonary dysplasia (BPD) is usually diagnosed in preterm infants at least 28 days after birth. Great interest lies in the potential to identify biomarkers that predict development of the disease and future neurodevelopmental outcomes. We have reviewed the existing literature on early biomarkers as predictors for BPD in preterm infants.

Methods

Two reviewers independently searched the databases of PubMed, EMBASE, and Google Scholar for studies pertaining to biomarkers for BPD. Studies were assessed using Quality Assessment of Diagnostic Accuracy Studies criteria.

Results

We identified 46 relevant articles that are summarized in the review. These studies assessed over 30 potential biomarkers. Sensitivity and specificity of biomarkers were reported or could be calculated for only 16 articles, and ranged from 0 to 100 %. Based on the nine highest quality studies, serum KL-6, CC16, neutrophil gelatinase-associated lipocalin, and end-tidal carbon monoxide (etCO) perform extremely well in predicting the early diagnosis of established BPD, highlighting these biomarkers as promising candidates for future research.

Conclusions

Published data from studies on serum biomarkers and etCO suggest that biomarkers may have great potential to predict the subsequent BPD and neurodevelopmental outcomes. These biomarkers need validation in larger studies, and the generalizability of biomarkers for predicting BPD, as well as the neurodevelopmental outcomes, needs to be further explored.

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Funding

This work was supported by the Hangzhou Science and Technology Development Project (grant number 201108331302) and the Open Foundation of Key Laboratory of Reproductive Genetics, Ministry of Education/Key Laboratory for diagnosis and therapy of neonatal diseases, China (grant number 2012-RG/ND-0004).

Conflict of interest statement

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Hangzhou First People’s Hospital, No. 261 Huansha Road, Hangzhou, Zhejiang, 310002, China

    Zhi-Qun Zhang & Hui Lu

  2. Department of Pediatrics, Hangzhou First People’s Hospital, No. 261 Huansha Road, Hangzhou, Zhejiang, 310002, China

    Xian-Mei Huang

Authors
  1. Zhi-Qun Zhang
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Correspondence to Xian-Mei Huang.

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Zhang, ZQ., Huang, XM. & Lu, H. Early biomarkers as predictors for bronchopulmonary dysplasia in preterm infants: a systematic review. Eur J Pediatr 173, 15–23 (2014). https://doi.org/10.1007/s00431-013-2148-7

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  • DOI: https://doi.org/10.1007/s00431-013-2148-7

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