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

C G Weismann1,2, J D Asnes1, A Bazzy-Asaad3

  • 1Department of Pediatrics, Division of Pediatric Cardiology, Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, CT, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 17, 2017
PubMed

Insights

Pulmonary hypertension (PH) is more common in preterm infants with bronchopulmonary dysplasia (BPD). Necrotizing enterocolitis (NEC) is a key factor associated with PH in these infants, potentially refining screening protocols.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Respiratory Medicine

Background:

  • Pulmonary hypertension (PH) poses a significant risk in preterm infants.
  • Identifying risk factors and optimizing screening for PH in vulnerable neonates is crucial.

Purpose of the Study:

  • To determine the prevalence of PH in preterm infants.
  • To identify factors associated with PH in preterm infants with and without bronchopulmonary dysplasia (BPD).

Main Methods:

  • Prospective echocardiographic screening was performed on preterm infants (<32 weeks' gestational age).
  • Infants were categorized into two groups: those with BPD and those without BPD but with risk factors for PH.
  • Associations between clinical factors (e.g., necrotizing enterocolitis, intraventricular hemorrhage) and PH were analyzed.

Main Results:

  • PH prevalence was higher in infants with BPD (28%) compared to those without BPD (11%).
  • In infants with BPD, lower birth weight, lower gestational age, necrotizing enterocolitis (NEC), severe intraventricular hemorrhage (IVH), atrial septal defect (ASD), and mortality were associated with PH.
  • NEC was the only identified factor associated with PH in infants without BPD.

Conclusions:

  • PH in preterm infants is associated with NEC, regardless of BPD status.
  • In preterm infants with BPD, factors like prematurity, IVH, ASD, and mortality are also linked to PH.
  • Targeted screening, focusing on infants with NEC and specific BPD criteria, could improve efficiency and reduce unnecessary echocardiograms.
Abstract

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