Increase in cord blood soluble E-selectin and tracheal aspirate neutrophils at birth and the development of new bronchopulmonary dysplasia

Aim: To test the hypothesis that preterm infants who develop new type of bronchopulmonary dysplasia BPD have higher cord blood sE-selectin levels and neutrophil counts in the tracheal aspirate at birth than those who do not. Methods: The relationship between cord blood sE-selectin levels and neutrophil counts in the tracheal aspirate at birth and the development of BPD was examined in 30 preterm infants. Levels of sE-selectin and neutrophil counts were measured by specific immunoassay and by cytospin analysis. Results: Median cord blood levels of sE-selectin and neutrophil counts in the tracheal aspirate at birth were higher in preterm infants who developed BPD than in those who did not (P<0.01 for each). These differences persisted significantly after adjusting for the effects of gestational age and the presence of histologic chorioamnionitis and patent ductus arteriosus PDA (P<0.01 for each). Conclusion: Fetal pulmonary inflammation, as measured by increased cord blood levels of sE-selectin and neutrophil counts in the tracheal aspirate at birth, may be a risk factor for the development of new BPD in preterm infants. These results support the hypothesis that the lung injury responsible for new BPD in preterm infants can begin in the prenatal period and could be associated with a fetal pulmonary inflammation.