The discovery BPD (D-BPD) program: study protocol of a prospective translational multicenter collaborative study to investigate determinants of chronic lung disease in very low birth weight infants.

BACKGROUND: Premature birth is a growing and serious public health problem affecting more than one of every ten infants worldwide. Bronchopulmonary dysplasia (BPD) is the most common neonatal morbidity associated with prematurity and infants with BPD suffer from increased incidence of respiratory infections, asthma, other forms of chronic lung illness, and death (Day and Ryan, Pediatr Res 81: 210-213, 2017; Isayama et la., JAMA Pediatr 171:271-279, 2017). BPD is now understood as a longitudinal disease process influenced by the intrauterine environment during gestation and modulated by gene-environment interactions throughout the neonatal and early childhood periods. Despite of this concept, there remains a paucity of multidisciplinary team-based approaches dedicated to the comprehensive study of this complex disease. METHODS: The Discovery BPD (D-BPD) Program involves a cohort of infants < 1,250 g at birth prospectively followed until 6 years of age. The program integrates analysis of detailed clinical data by machine learning, genetic susceptibility and molecular translation studies. DISCUSSION: The current gap in understanding BPD as a complex multi-trait spectrum of different disease endotypes will be addressed by a bedside-to-bench and bench-to-bedside approach in the D-BPD program. The D-BPD will provide enhanced understanding of mechanisms, evolution and consequences of lung diseases in preterm infants. The D-BPD program represents a unique opportunity to combine the expertise of biologists, neonatologists, pulmonologists, geneticists and biostatisticians to examine the disease process from multiple perspectives with a singular goal of improving outcomes of premature infants. TRIAL REGISTRATION: Does not apply for this study.

Estudio de la predicción clínica de la prematurez y el retardo de crecimiento intrauterino por factores de riesgo de la embarazada / Clinical prediction of prematurity and intrauterine growth retard ation by risk factors of the pregnant woman

Se estudió la capacidad predictiva de factores de riesgo de la embarazada en la producción de prematurez y retardo de crecimiento intrauterino. Aunque varios factores (mayor de 40 años, menor de 45 kg, ningún control del embarazo, muerte fetal previa, y sobre todo hipertensión en el embarazo) mostraron riesgo relativo incrementado, la sensibilidad de estos factores fue muy baja. Este hecho indica la organización de la atención según estos factores de riesgo y plantea la necesidad de nuevas modalidades de asistencia del embarazo a fin de prevenir el daño perinatal