– Methylation alterations impact immune responses in premature neonates. – Epigenetic markers in cord blood DNA are associated with BPD risk. – Studies show differential patterns of hypomethylation and hypermethylation in BPD patients. – Specific genes (e.g., CTSH, SPOCK2) linked to BPD identified through epigenome-wide association studies. – Elevated neutrophil-to-lymphocyte ratio (NLR) may indicate higher BPD risk. This evidence concerns the gene SPOCK2 and bronchopulmonary dysplasia.