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Am J Perinatol 2017; 34(08): 801-807
DOI: 10.1055/s-0037-1598246
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evidence of Early Pulmonary Hypertension Is Associated with Increased Mortality in Very Low Birth Weight Infants

Andrew Berenz
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
,
Jeffrey E. Vergales
2   Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
,
Jonathan R. Swanson
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
,
Robert A. Sinkin
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
› Author Affiliations
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Publication History

26 August 2016

06 January 2017

Publication Date:
15 February 2017 (online)

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Abstract

Objective The objective of this study was to describe the inhospital outcomes of a high-risk cohort of very low birth weight infants with evidence of pulmonary hypertension (PHT) within the first 2 weeks after delivery.

Design A retrospective cohort study of consecutively admitted neonates with birth weight < 1,500 g admitted to a Level IV neonatal intensive care unit who were evaluated by echocardiogram between 72 hours and 14 days.

Results A total of 343 eligible infants were included in the cohort with a median gestational age of 25.5 weeks and birth weight of 790 g. Evidence of early PHT was associated with birth weight Z-score (odds ratio [OR]: 0.65, confidence interval [CI]: 0.48–0.87) and maternal African American race (OR: 1.9, CI: 1.03–3.69). Early PHT was associated with decreased in-hospital survival compared with those with no evidence of PHT (OR: 2.0, CI: 1.02–3.90), and was associated with an increased rate of moderate-to-severe bronchopulmonary dysplasia at 36 weeks postmenstrual age (OR: 2.92, CI: 1.24–6.89).

Conclusion The presence of early PHT on echocardiogram between 72 hours and 14 days of age was associated with decreased in-hospital survival and worse pulmonary outcomes. This population represents a group of infants who warrant further investigation to improve outcomes.

Keywords

pulmonary hypertension - bronchopulmonary dysplasia - preterm - neonate - echocardiogram - patent ductus arteriosus

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