Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.
Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Pediatr Int. 2022 Jan;64(1):e15271. doi: 10.1111/ped.15271.
The incidence of pulmonary hypertension (PH) associated with bronchopulmonary dysplasia (BPD) has not been investigated in regional cohorts. The aim of this study was to clarify the incidence of PH associated with BPD in all very low birthweight infants (VLBWIs) born during the study period in Aichi Prefecture, Japan.
We conducted a retrospective observational cohort study of all VLBWIs born in Aichi Prefecture. The inclusion criteria were VLB, birth between 1 January 2015 and 31 December 2015, and admission to any neonatal intensive care unit in Aichi Prefecture. BPD28d and BPD36w were defined as the need for supplemental oxygen or any respiratory support at 28 days of age or 36 weeks of postmenstrual age (PMA). The primary outcome was the incidence of PH after 36 weeks' PMA (PH36w) in VLBWIs with BPD28d and BPD36w. The secondary outcomes were the clinical factors related to PH36w in BPD36w patients. Mann-Whitney U-test and Fisher's exact test were used for univariate analysis. Differences were considered statistically significant at P < 0.05. Risk ratio (RR) and 95% confidence interval (CI) were also evaluated.
A total of 441 patients were analyzed. A total of 217 and 131 patients met the definition of BPD28d and BPD36w, respectively. Nine patients were diagnosed with PH36w (4.2% and 6.9% of the BPD28d and BPD36w patients, respectively). The presence of oligohydramnios (RR, 2.71; 95% CI: 1.55-4.73, P = 0.014) and sepsis (RR, 3.62; 95% CI: 1.51-8.63, P = 0.025) was significant in the PH36w patients.
The incidence of PH36w was 4.2% and 6.9% in the BPD28d and BPD36w patients, respectively. Oligohydramnios and sepsis were significantly associated with PH36w in VLBWIs.
支气管肺发育不良（BPD）相关肺动脉高压（PH）的发生率尚未在区域性队列中进行研究。本研究的目的是阐明在日本爱知县研究期间出生的所有极低出生体重儿（VLBWIs）中与 BPD 相关的 PH 的发生率。
我们对爱知县出生的所有 VLBWI 进行了回顾性观察队列研究。纳入标准为 VLB、出生于 2015 年 1 月 1 日至 12 月 31 日之间，以及在爱知县任何新生儿重症监护病房住院。BPD28d 和 BPD36w 定义为 28 天龄或 36 周校正后胎龄（PMA）时需要补充氧气或任何呼吸支持。主要结局是 BPD28d 和 BPD36w 患者中 PH36w 的发生率。次要结局是 BPD36w 患者中与 PH36w 相关的临床因素。使用 Mann-Whitney U 检验和 Fisher 确切检验进行单变量分析。P<0.05 差异有统计学意义。还评估了风险比（RR）和 95%置信区间（CI）。
共分析了 441 例患者。分别有 217 例和 131 例患者符合 BPD28d 和 BPD36w 的定义。9 例患者被诊断为 PH36w（BPD28d 和 BPD36w 患者分别为 4.2%和 6.9%）。羊水过少（RR，2.71；95%CI：1.55-4.73，P=0.014）和败血症（RR，3.62；95%CI：1.51-8.63，P=0.025）在 PH36w 患者中具有显著意义。
BPD28d 和 BPD36w 患者中 PH36w 的发生率分别为 4.2%和 6.9%。羊水过少和败血症与 VLBWI 中的 PH36w 显著相关。
