Strategies for predicting the development of bronchopulmonary dysplasia in preterm infants

Introduction. The prevalence of bronchopulmonary dysplasia development as the outcome of respiratory distress syndrome in premature infants is high. However, not all infants with serious risk factors develop this pathology. The aim. To develop a prediction model and improve a comprehensive approach to the management of infants with bronchopulmonary dysplasia (BPD) based on the identified clinical, laboratory, and molecular genetic predictors of its development.

Materials and methods. The study included 309 premature infants: premature infants in the neonatal period with respiratory distress syndrome over the active stage (n = 63); premature infants with bronchopulmonary dysplasia (n = 176); premature infants aged 29 days and older without bronchopulmonary dysplasia, but diagnosed respiratory distress syndrome in the neonatal period (n = 70). In the study, clinical and anamnestic parameters were analyzed, and the concentration of angiogenesis biomarkers in the serum in 204 children was determined using enzyme-linked immunosorbent assay. Genetic testing was also performed on 170 patients.

Results. When studying the genetic characteristics, the representation of the nucleotide variant rs45488997 in the CCN2 gene was observed to be higher in BPD patients (p = 0.023). At the same time, the nucleotide variant rs12489516 in the CPA3 gene was significantly more common in patients without BPD (p = 0.03). Clinical and biochemical parameters of premature infants were also assessed. The most important ones for the development of BPD were identified. Based on the data obtained, two prognostic models were formed. The first is characterized by the use of the identified clinical indicators to assess the risk of BPD development. These include gestational age, birth weight, and duration of general respiratory support. The second model evaluates biochemical markers. It analyzes serum concentrations of VEGF-A, ANGPT2, ANGPT1, PDGF-BB, and PECAM-1.

Conclusion. The development of modern prognostic models and early prevention of BPD is a promising method for effective care of premature infants.

Contribution:
Basargina M.A. — study concept and design;
Basargina M.A., Illarionova M.S., Zhanin I.S., Snovskaya M.A., Zhuzhula A.A. — data collection and processing;
Savostyanov K.V. — statistical processing of the material;
Basargina M.A. — writing the text;
Basargina M.A., Savostyanov K.V., Semikina E.L. — editing the text.
All co-authors approved the final version of the article and are responsible for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 31, 2025
Accepted: November 27, 2025
Published: December 25, 2025

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