Abstract
BackgroundPulmonary hypertension (PH) is a common complication of bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBWIs). Although recent studies have increased awareness that PH contributes significantly to the high morbidity and mortality of BPD, the risk factors and clinical characteristics for PH in VLBWIs are little known.ObjectivesTo investigate the risk factors and clinical characteristics for BPD-associated pulmonary hypertension (BPD-PH) in VLBWIs.MethodsA retrospective case–control observational study of VLBWIs with BPD admitted to a neonatal intensive care unit (NICU) over 4 years. According to echocardiograms confirming elevated pulmonary artery pressure after 28 days after birth, we divided BPD infants into PH group (n = 18) and non-PH group (n = 65). We compared pre- and postnatal characteristics between VLBWIs with or without PH. Multivariable logistic regression analysis was conducted with backward selection.ResultsA total of 83 infants with BPD were divided into PH group (n = 18) or non-PH group (n = 65). The average birth weight of the infants with BPD was 1078.1 g. Compared with those infants of the non-PH group, the birth weight of BPD-PH infants was significantly lower (968.1 ± 187.7 vs. 1108.5 ± 185.8, P = 0.006). Infants in the PH group had a higher incidence of patent ductus arteriosus (PDA) and underwent longer durations of oxygen therapy and mechanical ventilation compared to those in the non-PH group. In all subjects, birth weight (OR 0.995; 95% CI 0.991–0.999; P = 0.025) and PDA (OR 13.355; 95% CI 2.950–60.469; P = 0.001) were found to be specific risk factors for BPD-PH in this cohort.ConclusionsThe study shows PDA and birth weight are specific risk factors for BPD-PH in VLBWIs.
Highlights
Pulmonary hypertension (PH) is a common complication of bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBWIs)
A total of 83 infants with BPD were divided into PH group (n = 18) or non-PH group (n = 65)
Birth history Compared with those premature infants of the non-PH group, the birth weight of BPD-associated pulmonary hypertension (BPD-PH) infants was significantly lower (P = 0.006)
Summary
Pulmonary hypertension (PH) is a common complication of bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBWIs). Recent studies have increased awareness that PH contributes significantly to the high morbidity and mortality of BPD, the risk factors and clinical characteristics for PH in VLBWIs are little known. Owing to the use of prenatal steroids and postnatal surfactant (PS), improved ventilator strategies and advanced nursing techniques, the survival rate of premature infants especially VLBWIs and extremely low birth weight infants (ELBWIs) have increased [1]. Sun et al BMC Cardiovasc Disord (2021) 21:514 complication of premature infants, has differed from its classical form described by Northway in 1967 [2,3,4]. PH is associated with high morbidity and mortality in premature infants with BPD.
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