Advanced

Pulmonary hypertension in preterm infants : results of a prospective screening program

Weismann, C G LU ; Asnes, J D; Bazzy-Asaad, A; Tolomeo, C; Ehrenkranz, R A and Bizzarro, M J (2017) In Journal of Perinatology 37(5). p.572-577
Abstract

OBJECTIVE: Determine prevalence and associations with pulmonary hypertension (PH) in preterm infants.

STUDY DESIGN: Prospective institutional echocardiographic PH screening at 36 to 38 weeks' corrected gestational age (GA) for infants born <32 weeks' GA who had bronchopulmonary dysplasia (BPD; group BPD), and infants without BPD who had a birth weight (BW) <750 g, or clinical suspicion for PH (group NoBPD).

RESULTS: Two hundred and four infants were screened (GA 25.9±2 weeks, BW 831±286 g). The PH prevalence in group BPD was higher than in group NoBPD (44/159 (28%) vs 5/45 (11%); P=0.028). In group BPD, BW and GA were lower in infants with PH compared with NoPH. Following correction for BW and GA, necrotizing... (More)

OBJECTIVE: Determine prevalence and associations with pulmonary hypertension (PH) in preterm infants.

STUDY DESIGN: Prospective institutional echocardiographic PH screening at 36 to 38 weeks' corrected gestational age (GA) for infants born <32 weeks' GA who had bronchopulmonary dysplasia (BPD; group BPD), and infants without BPD who had a birth weight (BW) <750 g, or clinical suspicion for PH (group NoBPD).

RESULTS: Two hundred and four infants were screened (GA 25.9±2 weeks, BW 831±286 g). The PH prevalence in group BPD was higher than in group NoBPD (44/159 (28%) vs 5/45 (11%); P=0.028). In group BPD, BW and GA were lower in infants with PH compared with NoPH. Following correction for BW and GA, necrotizing enterocolitis (NEC), severe intraventricular hemorrhage (IVH), atrial septal defect (ASD), and mortality were independently associated with PH in infants with BPD. In group NoBPD, NEC was the only identified factor associated with PH. Altogether, screening only those infants with NEC and infants with BPD who also had a BW <840 g would have yielded a 84% sensitivity for detecting PH, and reduced the number of screening echocardiograms by 43%.

CONCLUSIONS: PH in prematurity is associated with NEC in infants with and without BPD. In infants with BPD, smaller GA and BW, severe IVH, ASD and mortality are also associated with PH. Infants without identified PH-associated factors may not require routine echocardiographic PH screening.

(Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Birth Weight, Bronchopulmonary Dysplasia/complications, Connecticut/epidemiology, Echocardiography, Enterocolitis, Necrotizing/complications, Female, Gestational Age, Humans, Hypertension, Pulmonary/diagnostic imaging, Infant, Infant Mortality, Infant, Extremely Premature, Infant, Low Birth Weight, Infant, Newborn, Logistic Models, Male, Neonatal Screening, Prospective Studies
in
Journal of Perinatology
volume
37
issue
5
pages
572 - 577
publisher
Nature Publishing Group
external identifiers
  • scopus:85013083648
ISSN
0743-8346
DOI
10.1038/jp.2016.255
language
English
LU publication?
no
id
c4b66a9b-600c-4e26-a1b8-de8db0640386
date added to LUP
2019-01-25 14:39:10
date last changed
2019-10-15 06:57:01
@article{c4b66a9b-600c-4e26-a1b8-de8db0640386,
  abstract     = {<p>OBJECTIVE: Determine prevalence and associations with pulmonary hypertension (PH) in preterm infants.</p><p>STUDY DESIGN: Prospective institutional echocardiographic PH screening at 36 to 38 weeks' corrected gestational age (GA) for infants born &lt;32 weeks' GA who had bronchopulmonary dysplasia (BPD; group BPD), and infants without BPD who had a birth weight (BW) &lt;750 g, or clinical suspicion for PH (group NoBPD).</p><p>RESULTS: Two hundred and four infants were screened (GA 25.9±2 weeks, BW 831±286 g). The PH prevalence in group BPD was higher than in group NoBPD (44/159 (28%) vs 5/45 (11%); P=0.028). In group BPD, BW and GA were lower in infants with PH compared with NoPH. Following correction for BW and GA, necrotizing enterocolitis (NEC), severe intraventricular hemorrhage (IVH), atrial septal defect (ASD), and mortality were independently associated with PH in infants with BPD. In group NoBPD, NEC was the only identified factor associated with PH. Altogether, screening only those infants with NEC and infants with BPD who also had a BW &lt;840 g would have yielded a 84% sensitivity for detecting PH, and reduced the number of screening echocardiograms by 43%.</p><p>CONCLUSIONS: PH in prematurity is associated with NEC in infants with and without BPD. In infants with BPD, smaller GA and BW, severe IVH, ASD and mortality are also associated with PH. Infants without identified PH-associated factors may not require routine echocardiographic PH screening.</p>},
  author       = {Weismann, C G and Asnes, J D and Bazzy-Asaad, A and Tolomeo, C and Ehrenkranz, R A and Bizzarro, M J},
  issn         = {0743-8346},
  keyword      = {Birth Weight,Bronchopulmonary Dysplasia/complications,Connecticut/epidemiology,Echocardiography,Enterocolitis, Necrotizing/complications,Female,Gestational Age,Humans,Hypertension, Pulmonary/diagnostic imaging,Infant,Infant Mortality,Infant, Extremely Premature,Infant, Low Birth Weight,Infant, Newborn,Logistic Models,Male,Neonatal Screening,Prospective Studies},
  language     = {eng},
  number       = {5},
  pages        = {572--577},
  publisher    = {Nature Publishing Group},
  series       = {Journal of Perinatology},
  title        = {Pulmonary hypertension in preterm infants : results of a prospective screening program},
  url          = {http://dx.doi.org/10.1038/jp.2016.255},
  volume       = {37},
  year         = {2017},
}