Can Early Haemoglobin Level and Number of Blood Transfusions Predict Bronchopulmonary Dysplasia ?


Akyıldız C., Tüzün F., Akçura Y. D., Duman N., Keskinoğlu P., Özkan H.

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, vol.37, no.2, pp.87-95, 2023 (Peer-Reviewed Journal)

Abstract

Background: Currently, no practical biomarker has been discovered for early recognition of the development of bronchopulmonary dysplasia(BPD). This study aimed to evaluate the predictive value of early complete blood count (CBC) indices along with red blood cell transfusion(RBCT) frequency for the development of moderate/severe BPD, and to identify a promising predictive risk model for BPD.
Methods: In this cross-sectional study, one-hundred-sixty-two neonates born before the 32nd weeks of gestation were retrospectively. Predictive role of CBC parameters in the first three postnatal days(PD) and the number of RBCTs on weekly basis were evaluated by univariate/multivariate analysis as well as multivariate data mining processing.
Results: Despite several factors affected BPD development in univariate analysis, gestational age, PD3 haemoglobin level and frequency of RBCT were found to be the independent predictors of BPD in multivariate analysis. The haemoglobin<155 g/L in the PD3 predicted moderate/severe BPD with 60% sensitivity and 88% specificity(AUC 0.80). Having received at least one RBCT during the first three postnatal weeks had AUC 0.81(sensitivity 0.91,and specificity 0.81). During hospitalisation, more than four RBCT predicted moderate/severe BPD with 0.83 sensitivity and 0.93 specificity(AUC0.96). A model including gestational age, PD3 haemoglobin value, and number of RBCT predicted BPD risk with 87% sensitivity and 86% precision using data mining methods.
Conclusion: Results emphasise that even just one blood transfusion in the first weeks is an independent risk factor for BPD. Even though BPD is multifactorial, initial haemoglobin value and RBCT frequency may serve as non-invasive and practical parameters to estimate BPD development risk.