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. 2021 Jan;106(1):45-50.
doi: 10.1136/archdischild-2019-318531. Epub 2020 Jun 22.

Fate of pulmonary hypertension associated with bronchopulmonary dysplasia beyond 36 weeks postmenstrual age

Sanne Arjaans  1 , Meindina G Haarman  2 , Marcus T R Roofthooft  2 , Marian W F Fries  2 , Elisabeth M W Kooi  3 , Arend F Bos  3 , Rolf M F Berger  2
Affiliations

Fate of pulmonary hypertension associated with bronchopulmonary dysplasia beyond 36 weeks postmenstrual age

Sanne Arjaans et al. Arch Dis Child Fetal Neonatal Ed. 2021 Jan.

Abstract

Objective: To determine the survival and evolution of pulmonary hypertension (PH) associated with bronchopulmonary dysplasia (BPD) in extremely premature born infants beyond 36 weeks postmenstrual age (PMA).

Design: A single-centre retrospective cohort study from a university hospital.

Patients: Extremely preterm (gestational age <30 weeks and/or birth weight <1000 g) infants, born between 2012 and 2017, in the University Medical Center Groningen with confirmed PH at/beyond 36 weeks PMA.

Main outcome measures: Survival, mortality rate and PH resolution. Patient characteristics, treatment, presence and evolution of PH were collected from patient charts.

Results: Twenty-eight infants were included. All had BPD, while 23 (82%) had severe BPD and 11 infants (39%) died. Survival rates at 1, 3 and 7 months from 36 weeks PMA were 89%, 70% and 58%, respectively. In 16 of the 17 surviving infants, PH resolved over time, with a resolution rate at 1 and 2 years corrected age of 47% and 79%, respectively. At 2.5 years corrected age, the resolution rate was 94%.

Conclusions: These extremely preterm born infants with PH-BPD had a survival rate of 58% at 6 months corrected age. Suprasystemic pulmonary artery pressure was associated with poor outcome. In the current study, infants surviving beyond the corrected age of 6 months showed excellent survival and resolution of PH in almost all cases. Prospective follow-up studies should investigate whether resolution of PH in these infants can be improved by multi-modal therapies, including respiratory, nutritional and cardiovascular treatments.

Keywords: cardiology; neonatology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Survival rate of all the 28 included infants is shown. The shading represents the 95% CI. In addition, the number of infants is shown. PMA, postmenstrual age.
Figure 2
Figure 2
Survival rate of all the 28 included infants, divided into pulmonary hypertension with subsystemic/systemic vs suprasystemic pulmonary arterial pressure. In addition, the number of infants is shown. A log-rank test was used for the comparison between the two groups. PMA, postmenstrual age.
Figure 3
Figure 3
Resolution rate during the follow-up of the 17 surviving infants is shown. The shading represents the 95% CI. In addition, the number of infants is shown. PH, pulmonary hypertension; PMA, postmenstrual age age.
Figure 4
Figure 4
Number of infants with pulmonary hypertension (PH) and the mortality and resolution rate of the included population are shown. X=infant censored due to loss to follow-up.
See this image and copyright information in PMC

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