10:20-10:30 Ultrasound-based monitoring of fetal lung development predicts the risk for respiratory infections in infants

Infancy is a window of increased sensitivity to respiratory infections. Besides postnatal environmental exposures, the origin of early-life lung dysfunction and thus, increased risk for respiratory infections may lie in fetal life. However, insights into early indicators and predictors for poor postnatal respiratory health are missing. To address this gap in knowledge, we here aimed to investigate whether a serial sonographic assessment of fetal lung growth can predict the risk for respiratory infections in infancy. Fetal lung growth was serially evaluated using transabdominal sonography in 133 pregnant women within the pregnancy cohort PRINCE (PRenatal determINants of Childrens’s hEalth) study. The lung area was determined by subtracting the cardiac area from the thoracic one at the fourchamber-level at at least three time points during pregnancy and fetal lung growth trajectories were accordingly designed. The number and type of respiratory infections in the first year of life was documented. To examine if the fetal lung growth trajectory can predict the respiratory infection risk in infancy, a Poisson regression model was applied. Using a machine learning approach, a novel model was developed to predict the risk for early-life respiratory infections based on fetal lung growth. An enhanced fetal lung growth throughout pregnancy was pinpointed as a predictor for a lower risk for early-life respiratory infections in boys and girls. Male sex was independently linked to an increased risk for respiratory infections in infancy. A highly accurate machine learning model to predict the risk for early-life respiratory infectionsin both boys and girls was designed. Model variables included known risk factors and novel predictors such as the sonographically assessed fetal lung growth trajectory. A serial sonographic assessment of fetal lung growth throughout pregnancy can serve as a predictor for the risk for respiratory infections in infancy