Sophie Breinig, Virginie Ehlinger, Jean-Christophe Roze, Laurent Storme, Heloise Torchin, Xavier Durrmeyer, Gilles Cambonie, Christophe Delacourt, Pierre-Henri Jarreau, Lionel Berthomieu, Olivier Brissaud, Valerie Benhammou, Geraldine Gascoinb, Catherine Arnaud, Pierre-Yves Ancelj
Children’s Hospital and Toulouse University. Nantes University Hospital. Lille University Hospital. Assistance Publique-Hôpitaux de Paris. CHI Créteil. Montpellier University Hospital. Necker Children’s Hospital. Bordeaux University Hospital. Epidemiology and Biostatistics Sorbonne.
France
Early Human Development
Early Hum Dev 2023; 184
DOI: 10.1016/j.earlhumdev.2023.105837
Abstract
Objective: To determine the prevalence, short-term prognosis and pharmacologic management of pulmonary hypertension (PH) among very preterm infants born before 32 weeks gestation (WG).
Study design: In the EPIPAGE-2 French national prospective population-based cohort of preterm infants born in 2011, those presenting with PH were identified and prevalence was estimated using multiple imputation. The primary outcome was survival without severe morbidity at discharge and was compared between infants with or without PH after adjusting for confounders, using generalized estimating equations models. Subgroup analysis was performed according to gestational age (GA) groups.
Results: Among 3383 eligible infants, 3222 were analyzed. The prevalence of PH was 6.0 % (95 % CI, 5.2-6.9), 14.5 % in infants born at 22-27+6 WG vs 2.7 % in infants born at 28-31+6 WG (P < .001). The primary outcome (survival without severe morbidity at discharge) occurred in 30.2 % of infants with PH vs 80.2 % of infants without PH (P < .001). Adjusted incidence rate ratios for survival without severe morbidity among infants with PH were 0.42 (0.32-0.57) and 0.52 (0.39-0.69) in infants born at 22-27+6 weeks gestation and those born at 28-31+6 weeks, respectively. Among infants with PH, 92.2 % (95 % CI, 87.7-95.2) received sedation and/or analgesia, 63.5 % (95 % CI, 56.6-69.9) received inhaled NO and 57.6 % (95 % CI, 50.9-64.0) received hemodynamic treatments.
Conclusion: In this population-based cohort of very preterm infants, the prevalence of PH was 6 %. PH was associated with a significant decrease of survival without severe morbidity in this population.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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