Clinical significance of early Pulmonary Hypertension in Preterm Infants

Sanne Arjaans; Marian W F Fries; Mirthe H Schoots; Carine F M Schilte; Marc T R Roofthooft; Elianne J L E Vrijlandt; Arie F Bos; Elisabeth M W Kooi; Rolf M F Berger

doi:10.1016/j.jpeds.2022.07.039

Clinical significance of early Pulmonary Hypertension in Preterm Infants

Sanne Arjaans^*, Marian W F Fries, Mirthe H Schoots, Carine F M Schilte, Marc T R Roofthooft, Elianne J L E Vrijlandt, Arie F Bos, Elisabeth M W Kooi, Rolf M F Berger

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To characterize different phenotypes of early pulmonary hypertension (PH) in preterm infants and their respective associations with bronchopulmonary dysplasia (BPD) and survival.

STUDY DESIGN: A prospective cohort study in a tertiary University Medical Centre from June 2016 until March 2019. Infants with a gestational age <30 weeks and/or a birth weight <1000 grams were included. Echocardiographic assessment for PH was performed 3-10 days after birth. Subsequent development of BPD at 36 weeks postmenstrual age and mortality were assessed.

RESULTS: Early-PH was identified in 55% of 104 included infants: 21% with persistent PH of the newborn (PPHN), 61% with flow-associated PH and 18% PH without-shunt. Only PPHN was associated with placental fetal vascular malperfusion, lower gestational age and low Apgar-scores. Both PPHN and flow-PH were associated with the development of BPD. Early-PH was associated with poorer survival, driven by PPHN.

CONCLUSIONS: Early-PH is highly prevalent (55%) in preterm infants and associated with the development of BPD, independent of the phenotype of PH. Infants with PPHN had the poorest survival. Early-PH presents in various phenotypes that are characterized by different etiology, pathophysiology, and associated long-term sequelae.

Original language	English
Pages (from-to)	74-81.e3
Number of pages	11
Journal	The Journal of Pediatrics
Volume	251
Early online date	4-Aug-2022
DOIs	https://doi.org/10.1016/j.jpeds.2022.07.039
Publication status	Published - Dec-2022

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Clinical Significance of Early Pulmonary Hypertension in Preterm InfantsFinal publisher's version, 579 KBLicence: CC BY

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@article{ed5cdc2d69b64830ab9dfb0b1255e196,

title = "Clinical significance of early Pulmonary Hypertension in Preterm Infants",

abstract = "OBJECTIVE: To characterize different phenotypes of early pulmonary hypertension (PH) in preterm infants and their respective associations with bronchopulmonary dysplasia (BPD) and survival.STUDY DESIGN: A prospective cohort study in a tertiary University Medical Centre from June 2016 until March 2019. Infants with a gestational age <30 weeks and/or a birth weight <1000 grams were included. Echocardiographic assessment for PH was performed 3-10 days after birth. Subsequent development of BPD at 36 weeks postmenstrual age and mortality were assessed.RESULTS: Early-PH was identified in 55% of 104 included infants: 21% with persistent PH of the newborn (PPHN), 61% with flow-associated PH and 18% PH without-shunt. Only PPHN was associated with placental fetal vascular malperfusion, lower gestational age and low Apgar-scores. Both PPHN and flow-PH were associated with the development of BPD. Early-PH was associated with poorer survival, driven by PPHN.CONCLUSIONS: Early-PH is highly prevalent (55%) in preterm infants and associated with the development of BPD, independent of the phenotype of PH. Infants with PPHN had the poorest survival. Early-PH presents in various phenotypes that are characterized by different etiology, pathophysiology, and associated long-term sequelae.",

author = "Sanne Arjaans and Fries, {Marian W F} and Schoots, {Mirthe H} and Schilte, {Carine F M} and Roofthooft, {Marc T R} and Vrijlandt, {Elianne J L E} and Bos, {Arie F} and Kooi, {Elisabeth M W} and Berger, {Rolf M F}",

year = "2022",

month = dec,

doi = "10.1016/j.jpeds.2022.07.039",

language = "English",

volume = "251",

pages = "74--81.e3",

journal = "The Journal of Pediatrics",

issn = "0022-3476",

publisher = "MOSBY-ELSEVIER",

}

TY - JOUR

T1 - Clinical significance of early Pulmonary Hypertension in Preterm Infants

AU - Arjaans, Sanne

AU - Fries, Marian W F

AU - Schoots, Mirthe H

AU - Schilte, Carine F M

AU - Roofthooft, Marc T R

AU - Vrijlandt, Elianne J L E

AU - Bos, Arie F

AU - Kooi, Elisabeth M W

AU - Berger, Rolf M F

PY - 2022/12

Y1 - 2022/12

N2 - OBJECTIVE: To characterize different phenotypes of early pulmonary hypertension (PH) in preterm infants and their respective associations with bronchopulmonary dysplasia (BPD) and survival.STUDY DESIGN: A prospective cohort study in a tertiary University Medical Centre from June 2016 until March 2019. Infants with a gestational age <30 weeks and/or a birth weight <1000 grams were included. Echocardiographic assessment for PH was performed 3-10 days after birth. Subsequent development of BPD at 36 weeks postmenstrual age and mortality were assessed.RESULTS: Early-PH was identified in 55% of 104 included infants: 21% with persistent PH of the newborn (PPHN), 61% with flow-associated PH and 18% PH without-shunt. Only PPHN was associated with placental fetal vascular malperfusion, lower gestational age and low Apgar-scores. Both PPHN and flow-PH were associated with the development of BPD. Early-PH was associated with poorer survival, driven by PPHN.CONCLUSIONS: Early-PH is highly prevalent (55%) in preterm infants and associated with the development of BPD, independent of the phenotype of PH. Infants with PPHN had the poorest survival. Early-PH presents in various phenotypes that are characterized by different etiology, pathophysiology, and associated long-term sequelae.

AB - OBJECTIVE: To characterize different phenotypes of early pulmonary hypertension (PH) in preterm infants and their respective associations with bronchopulmonary dysplasia (BPD) and survival.STUDY DESIGN: A prospective cohort study in a tertiary University Medical Centre from June 2016 until March 2019. Infants with a gestational age <30 weeks and/or a birth weight <1000 grams were included. Echocardiographic assessment for PH was performed 3-10 days after birth. Subsequent development of BPD at 36 weeks postmenstrual age and mortality were assessed.RESULTS: Early-PH was identified in 55% of 104 included infants: 21% with persistent PH of the newborn (PPHN), 61% with flow-associated PH and 18% PH without-shunt. Only PPHN was associated with placental fetal vascular malperfusion, lower gestational age and low Apgar-scores. Both PPHN and flow-PH were associated with the development of BPD. Early-PH was associated with poorer survival, driven by PPHN.CONCLUSIONS: Early-PH is highly prevalent (55%) in preterm infants and associated with the development of BPD, independent of the phenotype of PH. Infants with PPHN had the poorest survival. Early-PH presents in various phenotypes that are characterized by different etiology, pathophysiology, and associated long-term sequelae.

U2 - 10.1016/j.jpeds.2022.07.039

DO - 10.1016/j.jpeds.2022.07.039

M3 - Article

C2 - 35934129

SN - 0022-3476

VL - 251

SP - 74-81.e3

JO - The Journal of Pediatrics

JF - The Journal of Pediatrics

ER -

Clinical significance of early Pulmonary Hypertension in Preterm Infants

Abstract

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