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Characteristics and outcomes of preterm infants with early pulmonary hypertension

Rachel Mullaly1,2, Aisling Smith3, Claire Murphy3

  • 1Department of Neonatology, The Rotunda Hospital, Dublin, Ireland. rachelmullaly21@rcsi.ie.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 11, 2025
PubMed

Insights

Preterm infants with early pulmonary hypertension (PH) face significantly higher mortality rates and distinct echocardiographic findings. Early detection and management of PH in premature infants are crucial for improving survival and long-term outcomes.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Perinatology

Background:

  • Pulmonary hypertension (PH) is a serious complication in preterm infants.
  • Understanding the incidence, outcomes, and echocardiographic features of early PH is critical for clinical management.

Purpose of the Study:

  • To investigate the incidence, outcomes, and echocardiographic characteristics of preterm infants with early pulmonary hypertension (PH).
  • To compare these features between infants with and without early PH.

Main Methods:

  • A prospective observational study included infants born before 29 weeks gestation.
  • Echocardiograms were performed at 24-48 hours and 36 weeks postmenstrual age (PMA).
  • Early PH was defined by ductal shunting (bidirectional or right-to-left).

Main Results:

  • Early PH was identified in 12% (20/166) of infants.
  • Infants with early PH exhibited significantly higher mortality (55% vs 11%).
  • Distinct echocardiographic differences in cardiac function (twist, torsion, systolic time, isovolumic relaxation time) were observed, persisting in survivors at 36 weeks PMA.

Conclusions:

  • Early PH in preterm infants is associated with increased mortality and unique echocardiographic profiles.
  • Functional cardiac alterations in survivors persist until 36 weeks PMA.
  • Timely identification and targeted interventions for early PH may enhance outcomes in preterm neonates.
Abstract

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