Early pulmonary hypertension tied to bronchopulmonary dysplasia in preemies

Early pulmonary hypertension (PH) is highly prevalent among infants born preterm and appears to be related to the development of bronchopulmonary dysplasia (BPD), a recent study has found.

The prospective cohort study included 104 preterm infants born at gestational age <30 weeks and/or birth weight <1,000 g. PH was determined using echocardiography 3–10 days after birth, while BPD development was assessed at 36 weeks postmenstrual age.

Early PH was confirmed in 57 infants, yielding a prevalence rate of 55 percent. Of these, 65 percent (n=35) had flow PH, 21 percent (n=12) had persistent PH of the newborn, and 18 percent (n=10) had PH without shunt.

Overall, 45 preterm infants developed BPD, with an incidence rate of 47 percent. Fifteen patients (33 percent) had severe BPD.

Logistic regression analysis revealed that early PH was associated with BPD, increasing the likelihood of its development by 34 percent (odds ratio [OR], 1.34, 95 percent confidence interval [CI], 1.11–1.63).

Of the PH subtypes, both persistent PH of the newborn (OR, 1.52, 95 percent CI, 1.04–2.22) and flow PH (OR, 1.32, 95 percent CI, 1.08–1.63) were significantly associated with higher odds of BPD. No such effect was reported for PH without shunt (OR, 0.83, 95 percent CI, 0.60–1.15).

“Further studies are needed to investigate whether identification of early PH and its phenotype will allow for customized preventive therapies aimed at reducing long-term sequelae,” the researchers said.