Frequency of bronchopulmonary dysplasia in very low birth weight infants and its relationship with platelet mass index

This retrospective study aimed to evaluate the association between the development of bronchopulmonary dysplasia (BPD) and platelet mass index (PMI), as well as other hematological parameters (mean platelet volume, platelet, neutrophil, leukocyte, eosinophil, and monocyte counts), in preterm infants born before 32 weeks of gestation and with a birth weight below 1500 grams. The relationship between BPD and the presence of patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), respiratory distress syndrome (RDS), and sepsis was also investigated. A total of 141 preterm infants with a gestational age of ≤32 weeks and birth weight <1500 g, followed between 2020 and 2024, were included in the study. Laboratory data (complete blood count, biochemistry) obtained at birth and during the follow-up period, along with demographic and clinical variables, were collected retrospectively. For each infant, neonatal platelet count, MPV, and PMI (calculated by multiplying platelet count by MPV) values were recorded. The presence of complications such as PDA, RDS, ROP, BPD, and sepsis was documented. The diagnosis of BPD was made according to the criteria defined by Jobe and Bancalari, based on oxygen requirement at 36 weeks postmenstrual age, and the severity of BPD was classified as mild, moderate, or severe depending on the level of oxygen supplementation needed. Infants were grouped based on the presence and severity of BPD, and hematological parameters were compared between groups. The data were statistically analyzed, and a p-value <0.05 was considered significant. Statistical evaluations were performed using non- parametric tests, chi-square test, and multivariable logistic regression analysis. 111 A significant proportion of the included infants developed BPD. Platelet counts and platelet mass index (PMI) values in the early postnatal period (particularly on day 5) were significantly lower in infants who developed BPD compared to those who did not (p<0.05). Furthermore, infants with more severe BPD exhibited progressively lower platelet counts and PMI values over time, and these parameters showed statistically significant differences across BPD severity stages. In contrast, mean platelet volume (MPV) values were not significantly associated with either the development or severity of BPD (p>0.05). Platelet mass index (PMI) appears to be a potential marker that may contribute to early prediction of BPD in very low birth weight preterm infants. The marked differences observed in PMI and platelet counts suggest that these parameters could be useful in identifying infants at risk during the early neonatal period. Therefore, monitoring PMI may aid clinical decision-making in the risk assessment of BPD in preterm infants. In contrast, this study found that MPV did not possess predictive value for BPD. Keywords: Bronchopulmonary dysplasia, prematurity, platelet mass index, mean platelet volume, hematological marker