Risk factors and outcomes of early pulmonary hypertension in preterm infants

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Saad Ahmed Seth1, Amuchou Singh Soraisham1, Andrei Harabor1

  • 1a Department of Pediatrics, Section of Neonatology, Cumming School of Medicine , Alberta Children's Hospital Research Institute, University of Calgary , Calgary , Alberta , Canada.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|August 9, 2017
PubMed

Insights

Early onset pulmonary arterial hypertension (PAH) in preterm infants is common and linked to bronchopulmonary dysplasia and severe intraventricular hemorrhage. Treatment with inhaled nitric oxide showed good response and high survival rates.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Perinatal Medicine

Background:

  • Limited data exists on early pulmonary arterial hypertension (PAH) in preterm infants.
  • Outcomes for early-onset PAH (EOPAH) in neonates are conflicting.
  • Understanding risk factors and outcomes is crucial for this vulnerable population.

Purpose of the Study:

  • To examine risk factors for EOPAH in preterm infants.
  • To investigate neonatal outcomes associated with EOPAH.
  • To analyze data from a large perinatal center for early diagnosis (within 2 weeks of age).

Main Methods:

  • Case-control study design.
  • Matched preterm infants (<34 weeks) with EOPAH to controls based on gestational age, birth weight, and birth year.
  • Utilized univariate and multivariate analyses to assess risk factors and outcomes.

Main Results:

  • EOPAH occurred in 3.3% of preterm infants, with 95% diagnosed within the first week.
  • Infants with EOPAH showed higher rates of prolonged rupture of membranes and oligohydramnios, and lower antenatal steroid use.
  • EOPAH was associated with bronchopulmonary dysplasia (BPD), BPD/death, and severe intraventricular hemorrhage. Inhaled nitric oxide (iNO) was effective in 51 infants.

Conclusions:

  • Early-onset pulmonary arterial hypertension is a significant condition in preterm infants.
  • EOPAH is associated with adverse outcomes including BPD and severe intraventricular hemorrhage.
  • Inhaled nitric oxide demonstrates efficacy and high survival rates in treated infants.
Abstract

Keywords:
Inhaled nitric oxideneonateoligohydramniospretermpulmonary hypertension

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