Mustafa Senol Akin, Gökce Kas, Emre Aydin, Aslihan Kose Cetinkaya, Ibrahim Ece, Fatma Nur Sari, Evrim Alymac Dizdar
Ankara City Hospital Children’s Hospital and University of Health Sciences.
Turkey
Archives of Disease in Children Fetal and Neonatal Edition
Arch Dis Child Fetal Neonatal Ed 2024;
DOI: 10.1136/archdischild-2024-327169
Abstract
Background: Prematurity is a significant risk for bronchopulmonary dysplasia related pulmonary artery pressure.
Objective: To determine the association between pulmonary artery pressure in the early days of life and the development of bronchopulmonary dysplasia or mortality.
Methods: This prospective observational cohort study included infants born at <32 weeks and weighing <1500 g. Pulmonary artery pressure was measured between postnatal days 3 and 7. Pulmonary hypertension was defined as systolic pulmonary artery pressure ≥40 mm Hg or systolic pulmonary artery pressure/systolic blood pressure >0.5 (pulmonary hypertension criterion-1). Infants were categorised into pulmonary hypertension and non-pulmonary hypertension groups. The primary endpoint was bronchopulmonary dysplasia or mortality. Receiver operating characteristic analysis established a new threshold value for predicting bronchopulmonary dysplasia or mortality (pulmonary hypertension criterion-2). Infants were reanalysed according to new criteria.
Results: A total of 329 infants were included in this study. Moderate-to-severe pulmonary hypertension was identified in 24% (n=79) of the infants. The pulmonary hypertension group exhibited a significantly lower gestational age, lower birth weight and a higher incidence of small for gestational age. Systolic pulmonary artery pressure >25 mm Hg or systolic pulmonary artery pressure/systolic blood pressure >0.35 was defined as the pulmonary hypertension criterion-2. Logistic regression analysis identified pulmonary hypertension criterion-2 as an independent risk factor for moderate-to-severe bronchopulmonary dysplasia or mortality (OR 2.67, 95% CI 1.3 to 5.51, p<0.01).
Conclusion: Pulmonary artery pressure exceeding 25 mm Hg in the early days of life may be considered a potential risk factor for bronchopulmonary dysplasia or mortality.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
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