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Published on: October 31, 2025
Cardiovascular impact and sequelae of bronchopulmonary dysplasia
Sushmita G Yallapragada1, Rashmin C Savani1, Kara N Goss2
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Insights
Cardiovascular and pulmonary systems are linked from fetal development through adulthood. Prematurity and bronchopulmonary dysplasia (BPD) increase risks for heart and vascular issues throughout life.
Area of Science:
- Cardiovascular Physiology
- Neonatal Medicine
- Pulmonary Medicine
Background:
- Cardiac, pulmonary, and vascular systems are intricately linked during fetal and postnatal development.
- Prenatal insults can lead to abnormal lung and blood vessel development, increasing the risk of bronchopulmonary dysplasia (BPD) in preterm infants.
- Cardiovascular complications can arise from or exacerbate pulmonary issues, impacting neonatal morbidity.
Purpose of the Study:
- To review the cardiovascular antecedents of BPD in fetuses.
- To examine the cardiovascular consequences of preterm birth and BPD in neonates.
- To explore the lifelong cardiovascular impact of prematurity and BPD.
Main Methods:
- Literature review focusing on cardiovascular and pulmonary development.
- Analysis of the relationship between fetal insults and BPD.
- Examination of neonatal and long-term cardiovascular outcomes in preterm infants with BPD.
Main Results:
- Abnormal fetal development due to insults can predispose to BPD and cardiovascular dysfunction.
- Neonatal cardiac and pulmonary maladaptation amplifies BPD risk and morbidity.
- Individuals with prematurity and BPD face increased risks of hypertension and cardiac dysfunction later in life.
Conclusions:
- Cardiovascular factors play a critical role in the development and progression of BPD.
- Interdisciplinary care addressing both cardiac and pulmonary health is crucial for preterm infants.
- Long-term cardiovascular surveillance is essential for individuals born prematurely, especially those with BPD.
Abstract:
The development, growth, and function of the cardiac, pulmonary, and vascular systems are closely intertwined during both fetal and postnatal life. In utero, placental, environmental, and genetic insults may contribute to abnormal pulmonary alveolarization and vascularization that increase susceptibility to the development of bronchopulmonary dysplasia (BPD) in preterm infants. However, the shared milieu of stressors may also contribute to abnormal cardiac or vascular development in the fetus and neonate, leading to the potential for cardiovascular dysfunction. Further, cardiac or pulmonary maladaptation can potentiate dysfunction in the other organ, amplify the risk for BPD in the neonate, and increase the trajectory for overall neonatal morbidity. Beyond infancy, there is an increased risk for systemic and pulmonary vascular disease including hypertension, as well as potential cardiac dysfunction, particularly within the right ventricle. This review will focus on the cardiovascular antecedents of BPD in the fetus, cardiovascular consequences of preterm birth in the neonate including associations with BPD, and cardiovascular impact of prematurity and BPD throughout the lifespan.
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