About this item:

323 Views | 400 Downloads

Author Notes:

Corresponding Author: Shilpa Vyas-Read, Phone: (404) 727-3360, Email: svyasre@emory.edu

Authors’ contributions SVR: conception and design, acquisition of data, interpretation of data, drafting of the manuscript, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work; UK: echocardiographic parameter selection and interpretation, critical revision of the manuscript, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work; PS: abstraction of data from clinical data warehouse, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work; JS: acquisition of data, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work; CT: database creation, interpretation of the data, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work; DPC: interpretation of data, critical revision of the manuscript, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work; AF: conception and design, interpretation of data, critical revision of the manuscript, final approval of the manuscript, and accountability ensuring accuracy and integrity of the work.

The authors would like to acknowledge Karen Parker for her aid in the submission of this manuscript.

The authors have no competing interests in the design, implementation, analysis or preparation of this manuscript.

The NIH was not involved in the 1) study design; 2) the collection, analysis, and interpretation of data; 3) the writing of the report; and 4) the decision to submit the manuscript for publication.

Shilpa Vyas-Read wrote the first draft of the manuscript and no form of payment was given to anyone to produce the manuscript.

Subjects:

Research Funding:

Supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TROOO454

Keywords:

  • Atrial septal defect
  • Caffeine
  • Growth restriction
  • Pulmonary hypertension
  • Very low birth weight

Early characteristics of infants with pulmonary hypertension in a referral neonatal intensive care unit

Tools:

Journal Title:

BMC Pediatrics

Volume:

Volume 17, Number 1

Publisher:

, Pages 163-163

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: Approximately 8-23% of premature infants develop pulmonary hypertension (PH), and this diagnosis confers a higher possibility of mortality. As a result, professional societies recommend PH screening in premature infants. However, the risk factors for and the outcomes of PH may differ depending on the timing of its diagnosis, and little evidence is available to determine at-risk infants in the referral neonatal population. The objective of this study was to define clinical and echocardiographic characteristics of infants with pulmonary hypertension during the neonatal hospital course and at or near-term. Methods: Infants who had the following billing codes: < 32 weeks, birth weight < 1500 g, neonatal unit, and echocardiograph had records abstracted from a data warehouse at Children's Healthcare o f Atlanta. The outcome was defined as late PH on the final echocardiogram for all patients, and, separately, for patients with multiple studies. Descriptive statistics, univariable, and multivariable models were evaluated, and odds ratios and 95% confidence intervals are expressed below as (OR, CI). Results: 556 infants were included in the overall study, 59 had PH on their final echocardiogram (11%). In multivariable analyses, atrial septal defect (2.9, 1.4-6.1), and intrauterine growth restriction (2.7, 1.2-6.3) increased the odds of late PH, whereas caffeine therapy decreased PH (0.4, 0.2-0.8). When the analyses were restricted to 32 infants who had multiple echocardiograms during their hospitalization, the association between atrial septal defect (5.9, 2.0-16.5) and growth restriction (3.7, 1.3-10.7) and late PH was strengthened, but the effect of caffeine therapy was no longer significant. In this smaller subgroup, infants with late PH had their final echocardiogram at a median of 116 days of life, and 42-74% of them had right ventricular pathology. Conclusions: Early clinical variables are associated with PH persistence in a referral neonatal population. Identification of early clinical factors may help guide the ascertainment of infant risk for late PH, and may aid in targeting sub-groups that are most likely to benefit from PH screening.

Copyright information:

© 2017 The Author(s).

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
Export to EndNote