Department of Pediatrics, Division of Neonatology, Metro Health Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, 44109, USA.
World J Pediatr. 2014 Feb;10(1):46-52. doi: 10.1007/s12519-014-0464-2. Epub 2014 Jan 25.
To determine the characteristics and outcomes of pulmonary arterial hypertension (PAH) in extremely low birth weight (ELBW) infants.
A retrospective case-control study of all ELBW infants admitted to a level III neonatal intensive care unit (NICU) between January 1, 2003 and December 31, 2010.
During the study period, 450 ELBW infants were admitted. 6.4% (29/450) were diagnosed with PAH and were matched to 26 controls. The mean gestational age of infants with PAH and their controls were similar [24.5 ± 1.3 vs. 24.9 ± 1.8 weeks (P=0.26)]; however the cases were smaller at birth than were controls [640.7 ± 119.5 vs. 727.0 ± 184.5 g (P=0.04)]. The diagnosis of PAH was made at a mean postnatal age of 131.8 ± 53.7 days. Infants with PAH had a higher rate of intrauterine exposure to illicit maternal drug use [12/29 (41%) vs. 1/25 (4%); P=0.001], a longer duration of initial mechanical ventilation [74.9 ± 28.3 vs. 59.1 ± 27.8 days; P=0.04)], a higher incidence of severe BPD [23/29 (79%) vs. 13/26 (50%); P=0.02], and a greater NICU mortality rate [12/29 (41%) vs. 4/26 (15%); P=0.04].
PAH in ELBW infants is associated with maternal illicit drug use in pregnancy, longer exposure to mechanical ventilation, severe bronchopulmonary dysplasia and a significant increase in early mortality.
确定极低出生体重（ELBW）婴儿中肺动脉高压（PAH）的特征和结局。
对 2003 年 1 月 1 日至 2010 年 12 月 31 日期间入住三级新生儿重症监护病房（NICU）的所有 ELBW 婴儿进行回顾性病例对照研究。
在研究期间，有 450 名 ELBW 婴儿入院。6.4%（29/450）被诊断为 PAH，并与 26 名对照匹配。PAH 婴儿及其对照的平均胎龄相似[24.5 ± 1.3 与 24.9 ± 1.8 周（P=0.26）]；然而，病例组的出生体重小于对照组[640.7 ± 119.5 与 727.0 ± 184.5 g（P=0.04）]。PAH 的诊断平均在出生后 131.8 ± 53.7 天做出。PAH 婴儿宫内暴露于非法母亲药物的发生率更高[12/29（41%）与 1/25（4%）；P=0.001]，初始机械通气时间更长[74.9 ± 28.3 与 59.1 ± 27.8 天；P=0.04]，严重支气管肺发育不良发生率更高[23/29（79%）与 13/26（50%）；P=0.02]，新生儿重症监护病房死亡率更高[12/29（41%）与 4/26（15%）；P=0.04]。
ELBW 婴儿的 PAH 与母亲妊娠期间非法药物使用、更长时间的机械通气暴露、严重支气管肺发育不良以及早期死亡率显著增加有关。
