Abstract
Objectives:To evaluate the impact of pulmonary hypertension (PH) on long-term growth and neurodevelopmental outcomes of extremely preterm infants with bronchopulmonary dysplasia (BPD).Study Design:A single-center retrospective cohort of preterm infants born at <28 weeks gestational age from 2000 to 2011 was evaluated at 3 years of age. Growth and neurodevelopmental outcomes were compared among 3 groups: non-BPD, BPD without PH and BPD with PH. BPD was defined according to oxygen demand at 36 weeks postmenstrual age. PH was diagnosed by echocardiography during the neonatal intensive care unit stay.Results:Sixty-two infants without BPD, 60 with BPD without PH and 20 with BPD with PH were analyzed. Regardless of PH status, somatic growth was smaller in both BPD groups of infants than in non-BPD infants, with further reduction in the group having BPD with PH. Furthermore, a developmental quotient of <70 was more prevalent in the BPD infants with PH than in the BPD infants without PH (odds ratio (OR): 4.37; 95% confidence interval, CI: 1.16 to 16.5). Multivariate analysis demonstrated that BPD with PH was one of the independent perinatal risk factors for developmental quotient <70 at 3 years of age (OR: 4.94, 95% confidence interval: 1.06 to 24.1).Conclusion:PH had an additional negative effect on long-term growth and neurodevelopmental outcomes of extremely preterm infants with BPD.
Highlights
Despite remarkable improvement in neonatal intensive care for preterm infants, bronchopulmonary dysplasia (BPD) remains one of the most significant medical complications associated with higher morbidity and mortality
The aim of the present study was to determine the impact of BPD with or without pulmonary hypertension (PH) on long-term growth and neurodevelopmental outcomes of preterm infants born at o28 weeks gestational age (GA) and to determine the perinatal risk factors for developing PH
The major finding of our study was that PH status had an additional negative effect on the long-term growth and neurodevelopmental outcomes of extremely preterm infants with BPD
Summary
Despite remarkable improvement in neonatal intensive care for preterm infants, bronchopulmonary dysplasia (BPD) remains one of the most significant medical complications associated with higher morbidity and mortality. the incidence of BPD has not decreased in spite of the improved mortality rate among high-risk infants. Among many types of cardiorespiratory impairment, pulmonary hypertension (PH) is one of the major complications associated with BPD. most published reports have mentioned the overall incidence of PH in BPD, there have been few reports on the long-term neurodevelopmental outcomes of BPD infants with PH due to the high mortality rate during follow-up periods. Despite remarkable improvement in neonatal intensive care for preterm infants, bronchopulmonary dysplasia (BPD) remains one of the most significant medical complications associated with higher morbidity and mortality.. The incidence of BPD has not decreased in spite of the improved mortality rate among high-risk infants.. Most published reports have mentioned the overall incidence of PH in BPD, there have been few reports on the long-term neurodevelopmental outcomes of BPD infants with PH due to the high mortality rate during follow-up periods. The aim of the present study was to determine the impact of BPD with or without PH on long-term growth and neurodevelopmental outcomes of preterm infants born at o28 weeks gestational age (GA) and to determine the perinatal risk factors for developing PH
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