Sarah E. Diamond, Amy H. Stanford, Adrianne R. Bischoff, Patrick J. McNamara, Philip T. Levy
University of Arkansas for Medical Sciences and Arkansas Children’s Hospital. University of Iowa. Boston Children’s Hospital and Harvard Medical School.
United States
Journal of Perinatology
J Perinatol 2026;
DOI: 10.1038/s41372-026-02776-w
Abstract
Chronic pulmonary hypertension (cPH) associated with bronchopulmonary dysplasia (BPD) remains a major contributor to morbidity and mortality among preterm infants. Systematic screening enables earlier diagnosis, improves recognition of disease heterogeneity, and supports development of targeted management strategies. However, existing screening approaches vary and often emphasize treatment considerations without adequately distinguishing underlying hemodynamic phenotypes, including pulmonary vascular remodeling, systemic-to-pulmonary shunting with increased pulmonary blood flow, and left heart disease. This lack of mechanistic differentiation may delay appropriate therapy and expose infants to ineffective or harmful interventions. There is a critical need for standardized screening strategies that integrate physiologic phenotyping to better define disease contributors, severity, and longitudinal risk. The physiology of cPH is dynamic and changes over time. In this perspective, we propose a phenotype-integrated screening algorithm in BPD-associated cPH, focusing on identification of high-risk populations, optimal timing and modality of assessment, phenotype-directed management pathways, longitudinal follow-up, and coordinated multidisciplinary care.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No