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Mortality among infants with evolving bronchopulmonary dysplasia increases with major surgery and with pulmonary

L B DeVries1, R J Heyne1, C Ramaciotti2

  • 1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|June 16, 2017
PubMed

Insights

Pulmonary arterial hypertension (PAH) and major surgery significantly increase mortality risk in preterm infants with evolving bronchopulmonary dysplasia (BPD). These factors are independent predictors of death in this vulnerable population.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
  • Pulmonary arterial hypertension (PAH) and surgical interventions are potential complications in BPD management.
  • Understanding mortality predictors in BPD is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine if pulmonary arterial hypertension (PAH) and surgical procedures are independent risk factors for mortality in preterm infants with evolving bronchopulmonary dysplasia (BPD).

Main Methods:

  • Retrospective analysis of a birth cohort of preterm infants (2001-2014) with evolving BPD.
  • Classification of surgeries as minor or major.
  • Stepwise logistic regression analysis to assess mortality associations.

Main Results:

  • Mortality decreased with increasing gestational age and birth weight Z-score.
  • Pulmonary arterial hypertension (PAH) was strongly associated with increased mortality (aOR: 30).
  • Major surgery (aOR: 2.8) and the combination of PAH and surgery (aOR: 10.3) also significantly increased mortality risk.

Conclusions:

  • Pulmonary arterial hypertension (PAH) and major surgery are independent predictors of mortality in preterm infants with evolving bronchopulmonary dysplasia (BPD).
  • Early identification and management of PAH and careful consideration of surgical necessity are vital for this patient group.
Abstract

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