Late Breaking Abstract - Blood neutrophil count at birth correlates with bronchopulmonary dysplasia diagnosis at 36 weeks and worse lung function at 44 weeks post menstrual age in very preterm infants

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Background: Prematurity is a major risk factor for respiratory symptoms and poor lung function in childhood. Studies on animal models of bronchopulmonary dysplasia (BPD) showed that neutrophilic inflammation during lung development plays a pivotal role in the pathogenesis of the disease, resulting in impaired lung function. We hypothesised that high blood neutrophils at birth could be a risk factor for BPD development and for impaired lung function at 44 weeks postmenstrual age (PMA) in infants. Methods: Multicenter prospective study including very preterm infants (birth gestational age <32 weeks) from 4 different birth centers in Rome, Italy who started the respiratory follow-up at Policlinico Umberto I hospital after discharge. Blood count was recorded in the first 24h after birth, BPD diagnosis was placed at 36w PMA (Jensen criteria 2019), and tidal breathing analysis was performed for lung function assessment at 44w PMA. Results: 34 very preterm infants were enrolled (19 M, 15 F); 18 (52,9%) with BPD and 16 (47,1%) with no BPD (mean GA 27+3 vs 28+5). Absolute neutrophil number at birth was significantly higher in infants with diagnosis of BPD at 36w PMA (9,9x103 vs 2,2 x103 /µL, p=0,021). TPEF/TE was significantly lower in infants with BPD (18,4 vs 28,6%; p<0,001) compared to infants with no BPD. Finally, neutrophil to lymphocyte ratio at birth significantly and inversely correlated with lower TPEF/TE at 44w PMA (r=0,41; p=0,038). Conclusions: High neutrophil count at birth might be a risk factor for BPD development and worse lung function at 44 weeks in very preterm infants.

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