Grant: Project Grant

Bronchopulmonary dysplasia (BPD) is a common, major complication of premature birth, associated with developmental and health consequences that continue into adulthood. Prediction of who will have these problems is challenging using traditional definitions of disease. It is believed that underdevelopment and injury occur in both lung tissue and the blood vessels in the lungs, with a sophisticated interplay between them that contributes to lung disease seen in prematurity. New magnetic resonance imaging (MRI) techniques can delineate tissue structure with unprecedented granularity, assessing lung tissue, blood vessels and their interplay. The ability to identify, at an early stage, those infants destined for chronic lung disease with greater certainty will be useful in counselling families and critical for effective introduction of promising new BPD therapies. 319 infants born less than 29 weeks gestation will be recruited from 4 Canadian centres, including 5 babies who will receive stem cell therapy as part of a separate clinical trial. Babies will be evaluated at 36 weeks post-conception with lung MRI, oscillometry (lung function), echocardiogram (heart ultrasound) and lung ultrasound. Lung health will be assessed every 3 months by phone questionnaire and chart review. At 18-21 months post-conception, babies will undergo neurodevelopmental assessment and oscillometry. We will look at how well baseline MRI markers predict subsequent lung health and development, independently and combined with echocardiogram, lung ultrasound and traditional markers of BPD. We anticipate that these new MRI markers will provide safe, robust measures of present and future lung health in preterm-born babies. By identifying predictors of longer-term lung disease, clinicians will be able to allocate resources to babies at highest risk. Further, we envision that MRI will help identify babies who would benefit most from stem cell and other therapies, as well as measure treatment effects.