title: Evidence of Early Pulmonary Hypertension Is Associated with Increased Mortality in Very Low Birth Weight Infants.
abstract: ObjectiveThe objective of this study was to describe the inhospital outcomes of a high-risk cohort of very low birth weight infants with evidence of pulmonary hypertension (PHT) within the first 2 weeks after delivery.DesignA retrospective cohort study of consecutively admitted neonates with birth weight < 1,500 g admitted to a Level IV neonatal intensive care unit who were evaluated by echocardiogram between 72 hours and 14 days.ResultsA total of 343 eligible infants were included in the cohort with a median gestational age of 25.5 weeks and birth weight of 790 g. Evidence of early PHT was associated with birth weight Z-score (odds ratio [OR]: 0.65, confidence interval [CI]: 0.48-0.87) and maternal African American race (OR: 1.9, CI: 1.03-3.69). Early PHT was associated with decreased in-hospital survival compared with those with no evidence of PHT (OR: 2.0, CI: 1.02-3.90), and was associated with an increased rate of moderate-to-severe bronchopulmonary dysplasia at 36 weeks postmenstrual age (OR: 2.92, CI: 1.24-6.89).ConclusionThe presence of early PHT on echocardiogram between 72 hours and 14 days of age was associated with decreased in-hospital survival and worse pulmonary outcomes. This population represents a group of infants who warrant further investigation to improve outcomes.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Berenz
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Vergales
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Swanson
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sinkin
mesh_terms: D017668:Age of Onset; D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000175:diagnosis / Q000208:ethnology; D004452:Echocardiography / Q000379:methods; D005260:Female; D005865:Gestational Age; D017052:Hospital Mortality; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D013223:Statistics as Topic; D014768:Virginia