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与支气管肺发育不良早产儿早发性和迟发性肺动脉高压发展相关的因素。

Factors associated with development of early and late pulmonary hypertension in preterm infants with bronchopulmonary dysplasia.

机构信息

Department of Neonatal-Perinatal Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, USA.

Drexel University College of Medicine, Philadelphia, PA, USA.

出版信息

J Perinatol. 2020 Jan;40(1):138-148. doi: 10.1038/s41372-019-0549-9. Epub 2019 Nov 13.

Abstract

OBJECTIVE

To investigate factors associated with development of early and late pulmonary hypertension (E/LPH) in preterm infants with bronchopulmonary dysplasia (BPD).

STUDY DESIGN

A retrospective case-control observational study of preterm infants with BPD admitted to a level IV referral neonatal intensive care unit over 5 years. We compared pre- and postnatal characteristics between infants with or without BPD-associated EPH and LPH.

RESULTS

Fifty-nine out of 220 infants (26.8%) had LPH, while 85 out of 193 neonates (44%) had EPH. On multiple logistic regression, novel factors associated with development of BPD-LPH included presence of maternal diabetes, EPH, tracheostomy, tracheitis, intraventricular hemorrhage (IVH, grade ≥3) and systemic steroid use. For EPH, these were maternal diabetes, IVH grade ≥3, high frequency ventilator use, and absence of maternal antibiotics use.

CONCLUSION

We identified novel factors and confirmed previously established factors with development of LPH and EPH, which can help develop a screening strategy in BPD patients.

摘要

目的

探讨与支气管肺发育不良(BPD)早产儿早发性和晚发性肺动脉高压(E/LPH)发展相关的因素。

研究设计

这是一项回顾性病例对照观察研究,纳入了 5 年内入住四级转诊新生儿重症监护病房的 BPD 早产儿。我们比较了伴有或不伴有 BPD 相关 EPH 和 LPH 的婴儿的产前和产后特征。

结果

220 名婴儿中有 59 名(26.8%)患有 LPH,193 名新生儿中有 85 名(44%)患有 EPH。多元逻辑回归分析显示,与 BPD-LPH 发展相关的新因素包括母亲患有糖尿病、EPH、气管切开术、气管炎、脑室内出血(IVH,≥3 级)和全身类固醇使用。对于 EPH,这些因素包括母亲患有糖尿病、IVH 分级≥3 级、高频呼吸机使用和母亲未使用抗生素。

结论

我们确定了新的与 LPH 和 EPH 发展相关的因素,并证实了先前已建立的因素,这有助于制定 BPD 患者的筛查策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d218/7223406/eb70759ab804/41372_2019_549_Fig1_HTML.jpg

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