The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year. J Pediatr 2018 Dec;203:218-224.e3
Date
09/03/2018Pubmed ID
30172426Pubmed Central ID
PMC6460906DOI
10.1016/j.jpeds.2018.07.035Scopus ID
2-s2.0-85052752400 (requires institutional sign-in at Scopus site) 82 CitationsAbstract
OBJECTIVES: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia.
STUDY DESIGN: This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System.
RESULTS: Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10-4.73, P < .001), ventilator support at 36 weeks of postmenstrual age (60% vs 40%, P < .001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P < .001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P < .001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, P < .001), supplemental oxygen use (84% vs 61%, P < .001), and tube feeds (80% vs 46%, P < .001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95% CI 1.18-1.63, P < .001).
CONCLUSIONS: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.
Author List
Lagatta JM, Hysinger EB, Zaniletti I, Wymore EM, Vyas-Read S, Yallapragada S, Nelin LD, Truog WE, Padula MA, Porta NFM, Savani RC, Potoka KP, Kawut SM, DiGeronimo R, Natarajan G, Zhang H, Grover TR, Engle WA, Murthy K, Children's Hospital Neonatal Consortium Severe BPD Focus GroupAuthor
Joanne M. Lagatta MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Bronchopulmonary DysplasiaCohort Studies
Comorbidity
Echocardiography, Doppler
Female
Gestational Age
Hospital Mortality
Humans
Hypertension, Pulmonary
Infant
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal
Male
Multivariate Analysis
Patient Readmission
Pregnancy
Prevalence
Prognosis
Regression Analysis
Retrospective Studies
Severity of Illness Index
Survival Rate