The Value of Cord Blood CXCL10 and MMP8 as Biomarkers in Predicting Bronchopulmonary Dysplasia- A Retrospective Cohort Study

Objective: To evaluate whether cord blood C-X-C motif chemokine ligand 10 (CXCL10) and Matrix Metalloproteinase 8 (MMP8) predict bronchopulmonary dysplasia (BPD) in preterm infants. Methods: In this retrospective cohort study (January 2019–December 2023), we enrolled 272 preterm infants (22– 32 weeks’ gestation; birth weight 631– 1493 g) admitted to Baoding Maternal and Child Health Hospital. Mean gestational age was 27.31 ± 1.97 weeks and mean birth weight 1,166.44 ± 245.63 g. Neonates were classified into BPD (n = 90) and non-BPD (n = 182) groups. Cord-blood CXCL10 and MMP-8 were quantified by enzyme-linked immunosorbent assay (ELISA). Associations were evaluated using Spearman correlation, multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: Infants who developed BPD had lower birth weight and Apgar scores at 1 and 5 minutes, and were more likely to be born at < 28 weeks’ gestation, to have neonatal respiratory distress syndrome (NRDS), to require FiO 2 ≥ 30%, and to receive prolonged mechanical ventilation (all P < 0.05). Cord blood CXCL10 and MMP8 levels were significantly higher in the BPD group ( P < 0.001) and were positively correlated with each other (r = 0.332, P < 0.001). Multivariable analysis identified low birth weight, low Apgar scores, NRDS, prolonged mechanical ventilation, and elevated CXCL10 and MMP8 as independent risk factors for BPD. The combined CXCL10 and MMP8 model achieved an AUC of 0.902, significantly outperforming either biomarker alone. Conclusion: Elevated cord blood CXCL10 and MMP8 levels are strongly associated with BPD development. Their combined measurement may help identify preterm infants at risk, although external validation is warranted. Keywords: bronchopulmonary dysplasia, preterm infants, cord blood, C-X-C motif chemokine ligand 10, matrix metalloproteinase 8, clinical value