Naumburg Estelle, Söderström Lars, Huber Daniel, Axelsson Inge
Department of Clinical Science, Paediatrics, Umeå University, Umeå, Sweden.
Östersund Hospital, Unit of Research, Education and Development, Östersund, Sweden.
Pediatr Pulmonol. 2017 May;52(5):636-641. doi: 10.1002/ppul.23633. Epub 2016 Nov 1.
Pulmonary hypertension (PH) has been linked to preterm birth explained by congenital heart defects and pulmonary diseases.
Other factors may influence the risk of PH among adolescences and children born premature.
This national registry-based study assess risk of PH following premature birth adjusted for known risk factors.
PATIENT-SUBJECT SELECTION AND METHODOLOGY: All cases born 1993-2010, identified by diagnostic codes applicable to PH and retrieved from the Swedish Registry of Congenital Heart Disease (N = 67). Six controls were randomly selected and matched to each case by year of birth and hospital by the Swedish Medical Birth Register (N = 402). Maternal and infant data related to preterm birth, pulmonary diseases, and congenital defects were retrieved. The association between preterm birth and pulmonary hypertension was calculated by conditional logistic regression taking into account potential confounding factors.
One third of the cases and seven percent of the controls were born preterm in our study. Preterm birth was associated with PH, OR = 8.46 (95%CI 2.97-24.10) (P < 0.0001) even after adjusting for confounding factors. Other factors, such as acute pulmonary diseases, congenital heart defects, congenital diaphragm herniation, and chromosomal disorders were also associated with PH in the multivariate analysis.
Children and young adults born preterm are known to have an increased risk of PH, previously explained by congenital heart defects and pulmonary diseases. By adjusting for such factors, our study indicates that new factors may play a role in the risk of developing PH among children born preterm. Pediatr Pulmonol. 2017;52:636-641. © 2016 Wiley Periodicals, Inc.
肺动脉高压（PH）与早产有关，原因是先天性心脏缺陷和肺部疾病。
其他因素可能影响早产的青少年和儿童患PH的风险。
这项基于全国登记处的研究评估了早产并校正已知风险因素后发生PH的风险。
1993年至2010年出生的所有病例，通过适用于PH的诊断代码识别，并从瑞典先天性心脏病登记处检索（N = 67）。通过瑞典医疗出生登记处按出生年份和医院为每个病例随机选择并匹配六个对照（N = 402）。检索与早产、肺部疾病和先天性缺陷相关的母婴数据。考虑潜在混杂因素，通过条件逻辑回归计算早产与肺动脉高压之间的关联。
在我们的研究中，三分之一的病例和7%的对照为早产。即使校正混杂因素后，早产仍与PH相关，OR = 8.46（95%CI 2.97 - 24.10）（P < 0.0001）。多因素分析中，其他因素，如急性肺部疾病、先天性心脏缺陷、先天性膈疝和染色体疾病也与PH相关。
已知早产的儿童和年轻人患PH的风险增加，以前认为是由先天性心脏缺陷和肺部疾病所致。通过校正这些因素，我们的研究表明新因素可能在早产儿童患PH的风险中起作用。《儿科肺科杂志》。2017年；52:636 - 641。©2016威利期刊公司
