Berenz Andrew, Vergales Jeffrey E, Swanson Jonathan R, Sinkin Robert A
Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
Am J Perinatol. 2017 Jul;34(8):801-807. doi: 10.1055/s-0037-1598246. Epub 2017 Feb 15.
The objective of this study was to describe the inhospital outcomes of a high-risk cohort of very low birth weight infants with evidence of pulmonary hypertension (PHT) within the first 2 weeks after delivery. A retrospective cohort study of consecutively admitted neonates with birth weight < 1,500 g admitted to a Level IV neonatal intensive care unit who were evaluated by echocardiogram between 72 hours and 14 days. A total of 343 eligible infants were included in the cohort with a median gestational age of 25.5 weeks and birth weight of 790 g. Evidence of early PHT was associated with birth weight Z-score (odds ratio [OR]: 0.65, confidence interval [CI]: 0.48-0.87) and maternal African American race (OR: 1.9, CI: 1.03-3.69). Early PHT was associated with decreased in-hospital survival compared with those with no evidence of PHT (OR: 2.0, CI: 1.02-3.90), and was associated with an increased rate of moderate-to-severe bronchopulmonary dysplasia at 36 weeks postmenstrual age (OR: 2.92, CI: 1.24-6.89). The presence of early PHT on echocardiogram between 72 hours and 14 days of age was associated with decreased in-hospital survival and worse pulmonary outcomes. This population represents a group of infants who warrant further investigation to improve outcomes.
本研究的目的是描述出生后2周内有肺动脉高压（PHT）证据的极低出生体重高危婴儿队列的住院结局。对连续入住四级新生儿重症监护病房、出生体重<1500g且在72小时至14天接受超声心动图评估的新生儿进行回顾性队列研究。队列中共有343名符合条件的婴儿，中位胎龄为25.5周，出生体重为790g。早期PHT的证据与出生体重Z评分（优势比[OR]：0.65，置信区间[CI]：0.48-0.87）和母亲非裔美国人种族（OR：1.9，CI：1.03-3.69）相关。与无PHT证据的婴儿相比，早期PHT与住院生存率降低相关（OR：2.0，CI：1.02-3.90），并与月经后36周时中重度支气管肺发育不良的发生率增加相关（OR：2.92，CI：1.24-6.89）。在72小时至14天龄时超声心动图显示存在早期PHT与住院生存率降低和更差的肺部结局相关。这一人群代表了一组需要进一步研究以改善结局的婴儿。
