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Published on: October 19, 2013

Characteristics of pulmonary hypertension in preterm neonates

V H Kumar1, A A Hutchison, S Lakshminrusimha

  • 1Department of Pediatrics (Neonatology), State University of New York (SUNY) at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, New York 14222, USA. vkumar@upa.chob.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 3, 2007
PubMed

Insights

Pulmonary hypertension (PHT) in preterm infants is linked to low Apgar scores and certain prenatal conditions. Response to inhaled nitric oxide (iNO) therapy improves with increasing gestational age (GA) in these vulnerable infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Respiratory Medicine

Background:

  • Pulmonary hypertension (PHT) in preterm infants is a significant concern with limited data on risk factors and treatment response.
  • Understanding PHT development and inhaled nitric oxide (iNO) efficacy is crucial for improving outcomes in premature neonates.

Purpose of the Study:

  • To identify risk factors for PHT in infants born before 37 weeks gestational age (GA).
  • To evaluate the response to inhaled nitric oxide (iNO) therapy in preterm infants diagnosed with PHT.

Main Methods:

  • Retrospective chart review of infants (<37 weeks GA) with echocardiographic diagnosis of PHT within the first 4 weeks of life.
  • Matched control group (no PHT) for comparison, analyzing prenatal/postnatal characteristics, iNO response, and mortality.
  • Statistical analysis to determine independent predictors of PHT and factors associated with mortality.

Main Results:

  • Low Apgar scores, preterm premature rupture of membranes, oligohydramnios, pulmonary hypoplasia, and sepsis were independent predictors of PHT.
  • Mortality was significantly higher in the PHT group (26.2%) compared to controls (4.1%).
  • Response to iNO therapy increased with gestational age (GA), with infants <29 weeks GA showing poor response.

Conclusions:

  • Low Apgar scores, oligohydramnios, and pulmonary hypoplasia are associated with PHT development in preterm infants.
  • The efficacy of inhaled nitric oxide (iNO) for PHT in preterm infants is dependent on gestational age, improving with increased GA.
Abstract

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