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Temporal Profile of Early Pulmonary Hypertension in Preterm Infants
Hussnain Mirza1, James Ziegler2, Sara Ford2
1Center for Neonatal Care, Florida Hospital for Children, UCF College of Medicine, Orlando, Florida.
Insights
Pulmonary hypertension (PH) in preterm infants often resolves but can recur. Late PH may develop during hospitalization, linked to neonatal conditions like bronchopulmonary dysplasia.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Respiratory Medicine
Background:
- Pulmonary hypertension (PH) is a significant concern in preterm infants.
- Understanding the temporal course of PH is crucial for management.
Purpose of the Study:
- To investigate the temporal profile of pulmonary hypertension in preterm infants.
- To identify factors associated with the development and resolution of PH.
Main Methods:
- Serial echocardiography was performed on preterm infants (<28 weeks gestation) from 10-14 days to 36 weeks postmenstrual age.
- Infants were categorized into early PH and control groups.
- Clinical morbidities were recorded.
Main Results:
- Early PH was moderate and resolved in all infants, with one recurrence.
- Five infants without early PH developed late PH.
- Late PH development was associated with patent ductus arteriosus, bronchopulmonary dysplasia, and infection.
Conclusions:
- Early moderate PH in preterm infants typically resolves but recurrence is possible.
- Late-onset PH can emerge during hospitalization, often alongside other neonatal morbidities.
Abstract:
Objective The objective of this study was to study the temporal profile of pulmonary hypertension (PH) in preterm infants. Study Design Infants < 28 weeks were screened for early PH at 10 to 14 days of life. Infants with early PH (n = 10) and gestationally matched controls (n = 18) underwent serial echocardiography every 7 to 10 days until 36 weeks postmenstrual age. Results Groups with and without early PH were comparable except for higher Fio 2 by day 10 among infants with early PH. Early PH was moderate in extent and resolved in all infants with recurrence in one infant. Among infants without early PH, five infants developed late PH. In both groups, development of late PH occurred in association with important neonatal morbidities, such as patent ductus arteriosus, bronchopulmonary dysplasia, and infection. Conclusion Early moderate PH among preterm infants resolves over a variable time period but recurrence is possible. Late PH can appear during the course of hospitalization in association with other clinical morbidities.
