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ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 15 - 2024 |
doi: 10.3389/fphar.2024.1515030
Influence of Inhaled Nitric Oxide on Bronchopulmonary Dysplasia in Preterm Infants with PPHN or HRF at Birth: A Propensity Score Matched Study
Provisionally accepted
Xuerong Huang
1
# Lian Wang
1*
Guo-Bao Liang
1*
Sheng-Qian Huang
2*
Baoying Feng
3
Mu-Lin Yao
4*
# Xu-Fang Fan
5*
Lu Zhu
6*
Jing Zhang
7*
Meng-Jiao Wang
8*
Zhi Zheng
9*
Yao Zhu
9
Wen-Li Duan
5*
Jian Mao
7
FAN WU
6
Zhan-Kui Li
8*
Fa-Lin Xu
5*
Li Ma
4*
Qiu-Fen Wei
3*
Ling Liu
2*
Xin-Zhu Lin
10*- 1 Xiamen Clinical Research Center for Perinatal Medicine, Xiamen Maternal and Child Health Hospital, College of Medicine, Xiamen University, Xiamen, China
- 2 Maternal and Child Health Care Hospital of Guiyang City, Guiyang, Guizhou Province, China
- 3 Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
- 4 Hebei Provincial Children's Hospital, Shijiazhuang, Hebei Province, China
- 5 Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- 6 Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
- 7 Sheng Jing Hospital Affiliated, China Medical University, Shenyang, Liaoning Province, China
- 8 Northwest Women’s and Children’s Hospital, Xian, Shaanxi Province, China
- 9 Xiamen Maternal and Child Health Hospital, College of Medicine, Xiamen University, Xiamen, Fujian Province, China
- 10 Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
Background: Bronchopulmonary Dysplasia (BPD) is a chronic lung disease affecting preterm infants, with limited prevention and treatment options. Inhaled Nitric Oxide (iNO) is sometimes used to treat Persistent Pulmonary Hypertension of the Newborn (PPHN) and Hypoxemic Respiratory Failure (HRF), and its impact on BPD development remains debated.Objective:To assess whether iNO-related factors are potential contributors to the development of BPD Grade Ⅱ-Ⅲ in very premature infants(VPI) diagnosed with PPHN or HRF at birth using Propensity Score Matching (PSM).We conducted a retrospective cohort study of infants born at 22-32 weeks gestation with PPHN or HRF, treated with iNO for over three hours. PSM matched groups by gestational age, birth weight, and gender etc. Multivariate logistic regression evaluated the association between iNO treatment and BPD outcomes to identify influencing factors, while Restricted Cubic Spline (RCS) and mediation analysis examined iNO dose effects and potential mediators like mechanical ventilation time and oxygenation index(OI).Results:A higher initial iNO dose was significantly associated with a reduced risk of BPD Grade Ⅱ-Ⅲ (adjusted OR = 0.68, 95% CI: 0.52-0.89, P < 0.01). Additionally, administration of iNO within the first 7 days of life was identified as an important influencing factor No significant mediation effects were observed for factors such as mechanical ventilation time and OI..A higher initial iNO dose within the first 7 days was associated with a reduced risk of BPD Grade Ⅱ-Ⅲ in VPI with PPHN or HRF.
Keywords: BPD (bronchopulmonary dysplasia), Nitric oxide - NO, Very premature infant, PPHN (persistent pulmonary hypertension of the newborn), Hypoxemic respiratory failure
Received: 22 Oct 2024; Accepted: 25 Nov 2024.
Copyright: © 2024 Huang, Wang, Liang, Huang, Feng, Yao, Xu-Fang Fan, Zhu, Zhang, Wang, Zheng, Zhu, Duan, Mao, WU, Li, Xu, Ma, Wei, Liu and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
# Lian Wang, Xiamen Clinical Research Center for Perinatal Medicine, Xiamen Maternal and Child Health Hospital, College of Medicine, Xiamen University, Xiamen, China
Guo-Bao Liang, Xiamen Clinical Research Center for Perinatal Medicine, Xiamen Maternal and Child Health Hospital, College of Medicine, Xiamen University, Xiamen, China
Sheng-Qian Huang, Maternal and Child Health Care Hospital of Guiyang City, Guiyang, 550000, Guizhou Province, China
Mu-Lin Yao, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei Province, China
# Xu-Fang Fan, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
Lu Zhu, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
Jing Zhang, Sheng Jing Hospital Affiliated, China Medical University, Shenyang, 110004, Liaoning Province, China
Meng-Jiao Wang, Northwest Women’s and Children’s Hospital, Xian, 710061, Shaanxi Province, China
Zhi Zheng, Xiamen Maternal and Child Health Hospital, College of Medicine, Xiamen University, Xiamen, 361001, Fujian Province, China
Wen-Li Duan, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
Zhan-Kui Li, Northwest Women’s and Children’s Hospital, Xian, 710061, Shaanxi Province, China
Fa-Lin Xu, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
Li Ma, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei Province, China
Qiu-Fen Wei, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
Ling Liu, Maternal and Child Health Care Hospital of Guiyang City, Guiyang, 550000, Guizhou Province, China
Xin-Zhu Lin, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian Province, China
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