Document Type

Article

Publication Date

12-1-2018

Identifier

PMCID: PMC6460906 DOI: 10.1016/j.jpeds.2018.07.035

Abstract

OBJECTIVES: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia.

STUDY DESIGN: This was a multicenter, retrospective cohort study of 1677 infants bornChildren's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System.

RESULTS: Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10-4.73, P < .001), ventilator support at 36 weeks of postmenstrual age (60% vs 40%, P < .001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P < .001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P < .001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, P < .001), supplemental oxygen use (84% vs 61%, P < .001), and tube feeds (80% vs 46%, P < .001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95% CI 1.18-1.63, P < .001).

CONCLUSIONS: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.

Journal Title

The Journal of pediatrics

Volume

203

First Page

218

Last Page

224

MeSH Keywords

Bronchopulmonary Dysplasia; Cohort Studies; Comorbidity; Echocardiography, Doppler; Female; Gestational Age; Hospital Mortality; Humans; Hypertension, Pulmonary; Infant; Infant, Newborn; Infant, Premature; Intensive Care, Neonatal; Male; Multivariate Analysis; Patient Readmission; Pregnancy; Prevalence; Prognosis; Regression Analysis; Retrospective Studies; Severity of Illness Index; Survival Rate

Keywords

bronchopulmonary dysplasia; epidemiology; outcomes; pulmonary hypertension; BPD

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