Blood test predicts chronic lung disease in preterm babies

A blood test can help predict which preterm babies will go on to develop chronic lung disease, allowing for earlier diagnosis and more targeted treatments. That’s according to new research led by the Murdoch Children’s Research Institute (MCRI), which found that changes in certain blood proteins, alongside gestational age, birth weight and sex, strongly predicated bronchopulmonary dysplasia (BPD) within 72 hours of life.

BPD usually occurs when a baby’s lungs are damaged by respiratory support and the long-term use of oxygen. The disease affects 65% of preterm infants and results in lifelong chronic lung disease and neurodevelopmental disabilities.

As noted by MCRI’s Dr Prue Pereira-Fantini, “Our ability to predict, prevent and treat BPD is limited”, as the tool currently used for early prediction of BPD severity fails to look at the disease pathology. As a result, “A BPD diagnosis is usually made at 36 weeks post-menstrual age, which limits potential treatments that can minimise lung injury and improve respiratory outcomes,” Pereira-Fantini said.

The MCRI study, which examined 493 blood proteins, involved 23 babies born before 29 weeks’ gestation at The Royal Women’s Hospital. Changes found in 49 of these proteins were detected in babies who later developed BPD, as detailed in the American Journal of Respiratory Cell and Molecular Biology.

“Our team was able to identify certain proteins in the blood which, when combined with other key birth measures, may predict BPD as early as four hours post-birth,” Pereira-Fantini said. This provided a comprehensive map of what occurred in babies with BPD and gave valuable insight about key biological changes in the first few days of life.

MCRI Professor David Tingay said the ability to more accurately predict BPD within these first few days may allow for earlier diagnosis, more targeted treatments and better-informed counselling for families.

“Changes in BPD rates can be achieved if appropriate lung protective interventions are provided at the right time,” he said. “We can better tailor the care of these babies when we know how likely they are to experience lung damage and other complications.”

The team are now looking to create a lung injury assessment tool that could be used to assess all preterm babies admitted to a neonatal intensive care unit (NICU) or special care nursery for risk of BPD. According to Pereira-Fantini, “The tool, including a blood test, would provide clinicians with the ability to guide respiratory decisions from birth, giving these babies more chances towards a healthy life.”

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