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Risk Factors Associated With the Development of Late Pulmonary Artery Hypertension in Extremely Premature Infants

Paige E Condit1, John S Hokanson2, Vivek Balasubramaniam3

  • 1Division of Neonatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Pediatric Pulmonology
|February 13, 2025
PubMed

Insights

One in five extremely premature infants developed late pulmonary artery hypertension (PH). Respiratory disease severity, including bronchopulmonary dysplasia (BPD) grade, are key risk factors for PH in these vulnerable infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Respiratory Medicine

Background:

  • Pulmonary artery hypertension (PH) is a serious complication in extremely premature infants.
  • Identifying risk factors for late-onset PH is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To determine risk factors for developing pulmonary artery hypertension (PH) at 36 weeks' postmenstrual age (PMA) in infants born before 28 weeks' gestation.
  • To investigate the association between respiratory disease severity and the incidence of late PH.

Main Methods:

  • Retrospective cohort study of infants born < 28 weeks' gestation.
  • Echocardiography screening for PH at 36 weeks' PMA.
  • Comparison of characteristics between infants with and without late PH.

Main Results:

  • 20% of infants (20/99) developed late PH.
  • FiO2 requirement at 4 weeks, home oxygen use, and PDA closure were associated with PH.
  • Bronchopulmonary dysplasia (BPD) severity showed a linear association with PH risk (3.5-fold increased odds per BPD severity point).

Conclusions:

  • Late PH affects one in five extremely premature infants.
  • Respiratory disease severity, particularly BPD grade, is a significant predictor of late PH development.
Abstract

Keywords:
bronchopulmonary dysplasiaextreme prematuritypulmonary hypertension

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