Characteristics of pulmonary hypertension in preterm neonates.
OBJECTIVE
Characteristics of preterm infants who develop pulmonary hypertension (PHT) and their response to inhaled nitric oxide (iNO) are not well described. Our objective was to identify risk factors for PHT in infants <37 weeks gestational age (GA) and to evaluate their response to iNO.


METHODS
A retrospective chart review was conducted in infants <37 weeks GA born from July/2000 to October/2005 who had an echocardiographic diagnosis of PHT in the first 4 weeks of life. A comparison non-PHT group was generated matched for GA and birth date. Data on prenatal and postnatal characteristics, response to iNO and mortality were collected.


RESULTS
Low Apgar scores, preterm premature rupture of membranes, oligohydramnios, pulmonary hypoplasia and sepsis were independently predictive of PHT. Mortality was significantly higher in the PHT group (26.2% versus 4.1%; P<0.0001) compared to the control group. Low birth weight, severe intraventricular hemorrhage and male sex were significantly associated with death in infants with PHT. Thirty-seven percent (23/61) of infants with PHT were treated with inhaled NO. Infants < 29-week GA had poor response to iNO and the response to iNO increased with GA (P<0.02).


CONCLUSIONS
Low Apgar scores, oligohydramnios and pulmonary hypoplasia are associated with the development of PHT in premature infants. The percentage of infants responding to iNO increases with advancing GA.
Kumar
V H
VH
Department of Pediatrics (Neonatology), State University of New York (SUNY) at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, New York 14222, USA. vkumar@upa.chob.edu
Hutchison
A A
AA
Lakshminrusimha
S
S
Morin
F C
FC
Wynn
R J
RJ
Ryan
R M
RM
D000280:Administration, Inhalation; D001034:Apgar Score; D001724:Birth Weight; D001794:Blood Pressure; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008168:Lung / Q000002:abnormalities; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage*; D016104:Oligohydramnios; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications
D001993:Bronchodilator Agents; D009569:Nitric Oxide