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<p>To characterize longitudinal vascular endothelial growth factor (VEGF) trajectories and establish time-discriminative thresholds for bronchopulmonary dysplasia (BPD) severity stratification in extremely preterm neonates. Prospective observational cohort study with serial biomarker assessments. Tertiary neonatal intensive care unit in Suzhou, China (February 2022–January 2023). The cohort comprised 157 infants born at &lt; 30 weeks’ gestation with birth weights &lt; 1250&#xa0;g. After exclusions (<i>n</i> = 21), 136 infants completed the study protocol. BPD severity and weekly plasma VEGF levels (cord blood to postnatal day 28). Analyses included adjusted mixed-effects models for longitudinal trends and Receiver Operating Characteristic (ROC) curves with bootstrap 95% confidence intervals for discriminative accuracy. Infants developing moderate-to-severe BPD (<i>n</i> = 44) exhibited biphasic VEGF dysregulation: elevated cord blood levels (75.8 pg/mL, 95% CI: 63.2–88.4) followed by steep weekly decline (− 56.0 pg/mL/week, 95% CI: −62.5 to − 49.4), whereas no/mild BPD infants (<i>n</i> = 92) maintained stable trajectories (<i>P</i> &lt; 0.001, partial η<sup>2</sup> = 0.67). Discriminative performance varied temporally: at birth (AUC 0.88, 95% CI: 0.82–0.93; threshold ≥ 338.6 pg/mL), Day 14 (AUC 0.75, 95% CI: 0.66–0.84; threshold ≤ 232.2 pg/mL) and at Day 21 (AUC 0.91, 95% CI: 0.85–0.96; threshold ≤ 217.5 pg/mL), bootstrap validation confirmed robustness. Longitudinal VEGF trajectories from a parsimonious mixed‑effects model identified infants who developed moderate‑to‑severe BPD, supporting potential for early risk stratification requiring validation.</p>

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Association of early VEGF trajectories with bronchopulmonary dysplasia severity in preterm infants

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月27日

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  • Yu Lun,
  • Danfeng Gu,
  • Zuming Yang

摘要

To characterize longitudinal vascular endothelial growth factor (VEGF) trajectories and establish time-discriminative thresholds for bronchopulmonary dysplasia (BPD) severity stratification in extremely preterm neonates. Prospective observational cohort study with serial biomarker assessments. Tertiary neonatal intensive care unit in Suzhou, China (February 2022–January 2023). The cohort comprised 157 infants born at < 30 weeks’ gestation with birth weights < 1250 g. After exclusions (n = 21), 136 infants completed the study protocol. BPD severity and weekly plasma VEGF levels (cord blood to postnatal day 28). Analyses included adjusted mixed-effects models for longitudinal trends and Receiver Operating Characteristic (ROC) curves with bootstrap 95% confidence intervals for discriminative accuracy. Infants developing moderate-to-severe BPD (n = 44) exhibited biphasic VEGF dysregulation: elevated cord blood levels (75.8 pg/mL, 95% CI: 63.2–88.4) followed by steep weekly decline (− 56.0 pg/mL/week, 95% CI: −62.5 to − 49.4), whereas no/mild BPD infants (n = 92) maintained stable trajectories (P < 0.001, partial η2 = 0.67). Discriminative performance varied temporally: at birth (AUC 0.88, 95% CI: 0.82–0.93; threshold ≥ 338.6 pg/mL), Day 14 (AUC 0.75, 95% CI: 0.66–0.84; threshold ≤ 232.2 pg/mL) and at Day 21 (AUC 0.91, 95% CI: 0.85–0.96; threshold ≤ 217.5 pg/mL), bootstrap validation confirmed robustness. Longitudinal VEGF trajectories from a parsimonious mixed‑effects model identified infants who developed moderate‑to‑severe BPD, supporting potential for early risk stratification requiring validation.