Objective Endostatin is an anti-angiogenic growth factor. Together with pro-angiogenic growth factors endostatin acts to shape the developing vasculature. Dysregulation of angiogenesis is a component in the pathogenesis of bronchopulmonary dysplasia. We wanted to study whether the concentration of circulating endostatin at birth predicts the development of bronchopulmonary dysplasia in very low birth weight infants.

Methods Endostatin concentration was measured in cord plasma from 92 very low birth weight infants (gestational age under 32 weeks and birth weight under 1500 g) and from 48 healthy term infants (gestational age over 37 weeks and birth weight over 2500 g).

Results Endostatin concentration (mean±SD) in very low birth weight infants (88.7±29.4 ng/ml) was lower than in healthy term infants (124.1±31.8 ng/ml) (p<0.0001). Within the very low birth weight group no correlation existed between endostatin concentration and gestational age (r =  −0.012, p = 0.91) or birth weight (r =  −0.073, p = 0.49).

Very low birth weight infants who subsequently developed bronchopulmonary dysplasia (n = 19) had higher cord endostatin than those who did not (n = 73): 100.7±29.7 ng/ml vs. 85.6±28.7 ng/ml, p = 0.029. This association remained statistically significant after further adjustment for GA, pH and impaired artery umbilical flow in logistic regression analysis.

Conclusions Circulating endostatin in term infants was higher than in very low birth weight infants, suggesting a temporal pattern for fetal endostatin concentration. In very low birth weight infants a high concentration of circulating endostatin at birth is associated with the subsequent development of bronchopulmonary dysplasia.