Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life
Abstract Bronchopulmonary dysplasia (BPD) is a major complication in preterm infants, particularly those born before 33 weeks of gestation. Inhaled nitric oxide (iNO) is widely used to manage pulmonary hypertension (PH) and improve oxygenation, but its role in reducing BPD incidence in preterm infan...
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Nature Portfolio
2025-07-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-06055-0 |
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| author | Tasnim Azad Li Li Shuo Wang ShaoJie Yue XiaoHe Yu ZhengChang Liao ChuanDing Cao Ying Ding Mei Lv Teng Liu MeiYan Chu MingJie Wang |
| author_facet | Tasnim Azad Li Li Shuo Wang ShaoJie Yue XiaoHe Yu ZhengChang Liao ChuanDing Cao Ying Ding Mei Lv Teng Liu MeiYan Chu MingJie Wang |
| author_sort | Tasnim Azad |
| collection | DOAJ |
| description | Abstract Bronchopulmonary dysplasia (BPD) is a major complication in preterm infants, particularly those born before 33 weeks of gestation. Inhaled nitric oxide (iNO) is widely used to manage pulmonary hypertension (PH) and improve oxygenation, but its role in reducing BPD incidence in preterm infants with PH during the early postnatal period remains unclear. This study aimed to evaluate the impact of early iNO administration, both alone and in combination with pulmonary surfactant (PS), on the incidence of BPD in preterm infants diagnosed with PH within the first three days of life. A retrospective cohort study was conducted on 56 preterm infants (< 33 weeks gestation) with confirmed PH and hypoxemia (PaO₂ < 50 mmHg at FiO₂ ≥ 30%). Clinical outcomes, including BPD incidence, were compared between infants receiving iNO and/or PS and those who did not. Multivariate logistic regression was used to identify independent predictors of BPD. The incidence of BPD was significantly lower in the iNO group (15%) compared to the non-iNO group (63.9%) (P = 0.012). Infants receiving both iNO and PS demonstrated the best outcomes, with a marked reduction in BPD risk. Male gender and lack of PS therapy were associated with increased BPD risk. Multivariate analysis confirmed iNO (OR = 0.097, 95% CI: 0.014–0.682; P = 0.019) and PS (OR = 0.125, 95% CI: 0.021–0.728; P = 0.021) as independent protective factors against BPD. Early administration of iNO, particularly in combination with PS, significantly reduces the incidence of BPD in preterm infants with PH. These findings highlight the potential benefits of iNO and PS as preventive therapies in this high-risk population. Further prospective studies are needed to validate these results and guide clinical practice. |
| format | Article |
| id | doaj-art-991dceb101b245b78a152c5b46827eec |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-991dceb101b245b78a152c5b46827eec2025-08-20T03:03:33ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-06055-0Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of lifeTasnim Azad0Li Li1Shuo Wang2ShaoJie Yue3XiaoHe Yu4ZhengChang Liao5ChuanDing Cao6Ying Ding7Mei Lv8Teng Liu9MeiYan Chu10MingJie Wang11Department of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityDepartment of Neonatology, Xiangya Hospital, Central South UniversityAbstract Bronchopulmonary dysplasia (BPD) is a major complication in preterm infants, particularly those born before 33 weeks of gestation. Inhaled nitric oxide (iNO) is widely used to manage pulmonary hypertension (PH) and improve oxygenation, but its role in reducing BPD incidence in preterm infants with PH during the early postnatal period remains unclear. This study aimed to evaluate the impact of early iNO administration, both alone and in combination with pulmonary surfactant (PS), on the incidence of BPD in preterm infants diagnosed with PH within the first three days of life. A retrospective cohort study was conducted on 56 preterm infants (< 33 weeks gestation) with confirmed PH and hypoxemia (PaO₂ < 50 mmHg at FiO₂ ≥ 30%). Clinical outcomes, including BPD incidence, were compared between infants receiving iNO and/or PS and those who did not. Multivariate logistic regression was used to identify independent predictors of BPD. The incidence of BPD was significantly lower in the iNO group (15%) compared to the non-iNO group (63.9%) (P = 0.012). Infants receiving both iNO and PS demonstrated the best outcomes, with a marked reduction in BPD risk. Male gender and lack of PS therapy were associated with increased BPD risk. Multivariate analysis confirmed iNO (OR = 0.097, 95% CI: 0.014–0.682; P = 0.019) and PS (OR = 0.125, 95% CI: 0.021–0.728; P = 0.021) as independent protective factors against BPD. Early administration of iNO, particularly in combination with PS, significantly reduces the incidence of BPD in preterm infants with PH. These findings highlight the potential benefits of iNO and PS as preventive therapies in this high-risk population. Further prospective studies are needed to validate these results and guide clinical practice.https://doi.org/10.1038/s41598-025-06055-0Bronchopulmonary dysplasiaPreterm infantsInhaled nitric oxidePulmonary surfactantPulmonary hypertension |
| spellingShingle | Tasnim Azad Li Li Shuo Wang ShaoJie Yue XiaoHe Yu ZhengChang Liao ChuanDing Cao Ying Ding Mei Lv Teng Liu MeiYan Chu MingJie Wang Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life Scientific Reports Bronchopulmonary dysplasia Preterm infants Inhaled nitric oxide Pulmonary surfactant Pulmonary hypertension |
| title | Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life |
| title_full | Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life |
| title_fullStr | Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life |
| title_full_unstemmed | Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life |
| title_short | Inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants (< 33 weeks) with pulmonary hypertension within the initial 3 days of life |
| title_sort | inhaled nitric oxide as an independent intervention to lower the risk of bronchopulmonary dysplasia in preterm infants 33 weeks with pulmonary hypertension within the initial 3 days of life |
| topic | Bronchopulmonary dysplasia Preterm infants Inhaled nitric oxide Pulmonary surfactant Pulmonary hypertension |
| url | https://doi.org/10.1038/s41598-025-06055-0 |
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