Department of Neonatal-Perinatal Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
Drexel University College of Medicine, Philadelphia, PA, USA.
J Perinatol. 2020 Jan;40(1):138-148. doi: 10.1038/s41372-019-0549-9. Epub 2019 Nov 13.
To investigate factors associated with development of early and late pulmonary hypertension (E/LPH) in preterm infants with bronchopulmonary dysplasia (BPD).
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.
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.
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.
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。
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。
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。
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。