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Author Notes:

E-mail address: jlagatta@mcw.edu.

No conflicts of interest disclosed

Subjects:

Research Funding:

None declared

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • CHRONIC LUNG-DISEASE
  • PREMATURE-INFANTS
  • PREDICTING DEATH
  • OUTCOMES
  • BIRTH
  • CARE
  • SILDENAFIL
  • MORTALITY
  • LENGTH
  • BORN

The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year

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Journal Title:

Journal of Pediatrics

Volume:

Volume 203

Publisher:

, Pages 218-+

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objectives: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia. Study design: This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Results: Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10-4.73, P <.001), ventilator support at 36 weeks of postmenstrual age (60% vs 40%, P <.001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P <.001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P <.001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, P <.001), supplemental oxygen use (84% vs 61%, P <.001), and tube feeds (80% vs 46%, P <.001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95% CI 1.18-1.63, P <.001). Conclusions: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.

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© 2018 Elsevier Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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