Analysis of the Levels of CD40L and NGAL in Umbilical Cord Blood of Preterm Infants with Moderate to Severe Bronchopulmonary Dysplasia and Their Clinical Value: A Single-Center Retrospective Study

Weina Li,1 Xiuya Guo,1 Xian He,1 Huanhuan Ma,1 Yan Li,2 Linlin Fu,2 Xuemin Qie1 1Department of Neonatology, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China; 2Department of Pediatrics, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of ChinaCorrespondence: Xuemin Qie, Department of Neonatology, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China, Email [email protected]: To examine the concentrations of cluster of differentiation CD40 ligand (CD40L) and neutrophil gelatinase-associated lipocalin (NGAL) in preterm infants with moderate to severe bronchopulmonary dysplasia (BPD), as well as to elucidate their clinical implications.Methods: A cohort of 138 preterm infants admitted to the neonatal intensive care unit between January 2021 and October 2022 were enrolled and divided into two groups: moderate to severe BPD (n=14) and non-BPD controls (n=124). Clinical data were collected. CD40L and NGAL levels in umbilical cord blood were measured by ELISA. Pearson correlation analysis and multivariate logistic regression were performed to identify risk factors and evaluate diagnostic value using ROC curve analysis.Results: Infants with moderate to severe BPD had lower 1-minute Apgar scores, prolonged mechanical ventilation, and higher prevalence of maternal smoking and intrauterine infection (all P< 0.05). CD40L and NGAL levels were significantly higher in BPD infants (P< 0.001). Pearson analysis showed a strong positive correlation between CD40L and NGAL (r=0.800, P< 0.001). Multivariate logistic regression identified maternal smoking (OR=1.092, 95% CI: 1.030– 1.158), intrauterine infection (OR=1.136, 95% CI: 1.027– 1.256), elevated CD40L (OR=1.138, 95% CI: 1.042– 1.242), and NGAL (OR=1.270, 95% CI: 1.063– 1.518) as independent risk factors for BPD. ROC analysis confirmed the diagnostic utility of CD40L and NGAL, with combined assessment showing superior predictive performance.Conclusion: Elevated levels of CD40L and NGAL in umbilical cord blood of preterm infants with moderate to severe BPD suggest that these biomarkers have high diagnostic value for moderate to severe BPD.Keywords: bronchopulmonary dysplasia, preterm infants, umbilical cord blood, CD40L, NGAL, clinical value