Association Between Plasma Lysophosphatidic Acid Levels and Bronchopulmonary Dysplasia in Extremely Preterm Infants: A Prospective Study.

Background: Lysophosphatidic acid (LPA) is implicated in bronchopulmonary dysplasia (BPD) pathogenesis, but clinical evidence is lacking. This study aimed to investigate LPA levels in preterm infants with and without BPD and explore LPA as a biomarker for predicting BPD occurrence. Methods: Premature infants with a gestational age of <28 weeks or a birth weight of <1000 g were enrolled. Blood samples were collected at postnatal day (PD) 7, 28, and postmenstrual age (PMA) 36 weeks, and plasma LPA levels were measured using a commercial ELISA kit. Receiver operating characteristic curve (ROC) curve analysis determined the PD 28 cutoff for LPA, and multivariable regression analyzed LPA's independent contribution to BPD and exploratory outcomes. Result: Among the 91 infants enrolled in this study, 35 were classified into the nonBPD group and 56 into the BPD group. Infants with BPD had higher plasma LPA levels at PD 28 (6.467 vs. 4.226 mu g/mL, p = 0.034) and PMA 36 weeks (2.330 vs. 1.636 mu g/mL, p = 0.001). PD 28 LPA level of 6.132 mu g/mL was the cutoff for predicting BPD development. Higher PD 28 LPA levels (>= 6.132 mu g/mL) independently associated with BPD occurrence (OR 3.307, 95% CI 1.032-10.597, p = 0.044). Higher LPA levels correlated with longer oxygen therapy durations [regression coefficients (ss) 0.147, 95% CI 0.643-16.133, p =.034]. Conclusions: Infants with BPD had higher plasma LPA levels at PD 28 and PMA 36 weeks. Higher PD 28 LPA levels independently associated with an increased BPD risk.